Although it plays a central mechanical role in medial epicondylitis, the MCT serves surgically as a landmark for the pathology of medial epicondylitis as well as a means of identification and avoidance of the AOL proper. The MCT rises off the anterior inferior epicondyle with an oblique parasagittal orientation extending approximately 12 cm into the proximal forearm. Immediately posterior to the proximal 3 to 4 cm of the MCT is the AOL (see Fig. 45-1 ). There is a surgical interval between the MCT and AOL, but anatomically, they are contiguous over the proximal 50% to 75% of the AOL. The distal 25% to 50% of the AOL is separate from the MCT’s posterior margin, an interval that allows for independent surgical manipulation of MCT and AOL distally. Any surgical elevation of the MCT off the medial epicondyle, posterior to the MCT, by definition, violates the origin of the AOL.