Applied anatomical study of the modified anconeus flap approach

Area of Science:

• Orthopedic Surgery
• Anatomy
• Surgical Techniques

Background:

• Conventional surgical treatment for intercondylar humerus fractures carries risks of complications.
• Existing methods may require olecranon osteotomy or triceps tendon division.

Purpose of the Study:

• To evaluate a modified anconeus flap approach for intercondylar humerus fractures.
• To assess the adequacy of distal humeral articular surface exposure.
• To avoid olecranon osteotomy and triceps tendon transection.

Main Methods:

• Anatomical investigation of 20 adult cadaver upper limb specimens.
• Design and application of a modified anconeus flap approach combined with the medial paratricipital approach.
• Comparison of exposure extent with the triceps-reflecting anconeus pedicle approach.

Main Results:

• Identified anatomical features of the anconeus and triceps brachii tendon that facilitate the modified approach.
• Achieved 42.7% exposure of the distal humeral articular surface.
• Demonstrated the modified approach's ability to overcome limitations of traditional methods.

Conclusions:

• A novel modified anconeus flap approach provides adequate exposure for intercondylar humerus fractures.
• This technique obviates the need for olecranon osteotomy and extensive triceps tendon dissection.
• The approach is suggested as a primary option for surgeons familiar with the relevant anatomy.