Objective analysis of lateral elbow exposure with the extensor digitorum communis split compared with the Kocher...

Area of Science:

• Orthopedic Surgery
• Anatomy
• Surgical Approaches

Background:

• Radial head fractures are commonly treated via the Kocher interval.
• The extensor digitorum communis (EDC) splitting approach may offer better access to the anterior radial head.
• Cadaveric study to compare visualization between EDC split and Kocher interval approaches.

Purpose of the Study:

• Compare osseous and articular surface area visualization.
• Evaluate the efficacy of EDC splitting versus Kocher interval for radial head fracture exposure.
• Determine optimal surgical approach for anterior radial head visualization.

Main Methods:

• Utilized fresh frozen cadaveric upper extremities.
• Assessed four approaches: EDC splitting, modified Kocher, extended EDC splitting, and extended modified Kocher.
• Quantified visualized surface area using 3D modeling and surface scanning.

Main Results:

• EDC splitting provided 100% exposure of the anterior radial head, significantly more than the modified Kocher approach (68%).
• Extended approaches offered comparable visualization of the distal humerus, capitellum, radial head, and coronoid process.
• EDC splitting demonstrated superior anterior radial head visualization.

Conclusions:

• EDC splitting approach ensures reliable visualization of the anterior radial head.
• This approach minimizes soft-tissue dissection and potential iatrogenic injury to the lateral ulnar collateral ligament.
• Suggests EDC splitting as a potentially advantageous surgical technique for radial head fractures.