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Surgical approaches to the elbow
Emilie V Cheung1, Scott P Steinmann
1Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA 94063, USA.
Summary
Complex elbow surgeries require specialized surgical approaches due to the intricate anatomy. This study details posterior, medial, and lateral surgical techniques for managing challenging elbow injuries.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Surgical Techniques
Background:
- Elbow surgery presents challenges due to dense neurovascular and ligamentous structures.
- Complex elbow injuries necessitate precise surgical access for effective treatment.
Purpose of the Study:
- To review and categorize surgical approaches for complex elbow injuries.
- To provide guidance on selecting appropriate surgical exposures based on injury patterns.
Main Methods:
- Discussion of posterior surgical approaches: olecranon osteotomy, triceps-reflecting, triceps-splitting, triceps-reflecting anconeus pedicle flap, and paratricipital.
- Description of medial approaches targeting the ulnar nerve, anterior/posterior capsules, and coronoid process.
- Explanation of lateral approaches for radial head, capitellum, coronoid process, and capsular pathology.
Main Results:
- Posterior approaches offer access around the triceps tendon and anconeus muscle, extendable to the entire joint.
- Medial approaches facilitate access to key structures like the ulnar nerve and coronoid process.
- Lateral approaches are crucial for pathologies involving the radial head, capitellum, and anterior/posterior capsules.
Conclusions:
- A comprehensive understanding of various surgical exposures is vital for complex elbow injuries.
- Combining different approaches allows for tailored treatment of intricate elbow pathologies, including fracture fixation, arthroplasty, and capsular release.
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