The Boyd Interval: A Modification for Use in the Management of Elbow Trauma

Surgical exposure of the radial head, proximal radius, capitellum, and proximal ulna can be achieved through several different approaches. The most commonly used are: the Kocher, Kaplan, and extensor digitorum communis splitting. Each of these approaches has its own limitations and dangers. In this article we describe a modified version of the less commonly used Boyd approach. We have used this approach with a transosseous lateral collateral ligament and annular ligament repair for operative treatment of fractures involving the radial head, proximal radius, proximal ulna including the coronoid, capitellum, and lateral column of the distal humerus. In our experience, the approach results in superior exposure of the lateral elbow while minimizing the risk of injury to the posterior interosseous nerve.