Comprehensive review of surgical approaches to the elbow |
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Institution: | 1. Princess Royal University Hospital, Kings College Hospital, NHS Foundation Trust, Farnborough Common, Orpington, BR6 8ND, UK;2. Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, SE5 9RS, UK;1. Department of Orthopaedic Surgery, Cairo University Faculty of Medicine, Cairo, Egypt;2. Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt;1. Institute of Advanced Orthopaedics, MOSC Medical College, Kolenchery, 682311, Ernakulam, Kerala, India;2. Department of Radio Diagnosis, MOSC Medical College, Kolenchery, 682311, Ernakulam, Kerala, India;1. Dept of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India;2. Assistant Professor, Bone and Soft Tissue Services, Dept of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, India;3. Fellow, Bone and Soft Tissue Services, Dept of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, India;4. Assistant Professor (adhoc), Dept of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, India;1. Barking, Havering & Redbridge University Hospitals NHS Trust, England, UK;2. Kings College London Hospitals NHS Foundation Trust, England, UK |
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Abstract: | The choice of the most suitable surgical approach to the elbow forms the foundation of any successful elbow surgery. The surgical approach is based on the injury or pathology to be addressed and therefore specific anatomical details need to be considered. The surgeon must be comfortable with the bony, ligamentous and neurovascular anatomy of the elbow to consider and execute the best approach for each problem. This is an imperative to avoid iatrogenic injury.This article provides a detailed analysis, valuable technical tips, advantages and disadvantages of the most common approaches to the elbow. The lateral approaches include the Kocher, Kaplan and Extensor Digitorum Communis (EDC) Split approaches, the medial approaches include the Hotchkiss, Flexor carpi ulnaris (FCU) splitting approach, the Taylor and Scham approach. The anterior approach includes the anterior neurovascular interval approach and the posterior approaches include the Olecranon osteotomy, triceps sparing, triceps reflecting approach and finally the Boyd interval approach. The text and illustrations will provide a structured overview for the practicing surgeon. |
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Keywords: | Elbow approaches Kocher approach Kaplan approach Olecranon osteotomy approach Triceps on and triceps off approaches Anterior approach |
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