Advertisement

Archives of Orthopaedic and Trauma Surgery

, Volume 131, Issue 6, pp 747–751 | Cite as

Newcastle approach to the elbow, a cadaveric study

  • Rouin AmirfeyzEmail author
  • Damian Clark
  • Tom Quick
  • Neil Blewitt
Orthopaedic Surgery

Abstract

Aim

The aim of the current study was to assess the amount of the distal humerus articular surface exposed through the Newcastle approach, a posterior triceps preserving exposure of the elbow joint.

Method

Twenty-four cadaveric elbows (12 pairs) were randomized to receive one of the four posterior surgical approaches: triceps reflecting, triceps splitting, olecranon osteotomy and Newcastle approach. The ratio of the articular surface exposed for each elbow was calculated and compared.

Results

The highest ratio observed was for Newcastle approach (0.75 ± 0.12) followed by olecranon osteotomy (0.51 ± 0.1), triceps reflecting (0.37 ± 0.08) and triceps splitting (0.35 ± 0.07). The differences between Newcastle approach and other approaches were statistically significant (p = 0.003 vs. osteotomy and <0.0001 vs. triceps reflecting and splitting).

Conclusion

The Newcastle approach sufficiently exposes the distal humerus for arthroplasty or fracture fixation purposes. Its use is supported by the current study.

Keywords

Newcastle approach Posterior approach to the elbow Triceps preserving elbow approach 

Notes

Acknowledgments

The authors would like to thank Mr. Joe Pooley for his support and teachings.

References

  1. 1.
    Patterson SD, Bain GI, Mehta JA (2000) Surgical approaches to the elbow. Clin Orthop Relat Res 370:19–33PubMedCrossRefGoogle Scholar
  2. 2.
    Celli A, Arash A, Adams RA, Morrey BF (2005) Triceps insufficiency following total elbow arthroplasty. J Bone Joint Surg [Am] 87:1957–1964CrossRefGoogle Scholar
  3. 3.
    Marra G, Morrey BF, Gallay SH, McKee MD, O’Driscoll S (2006) Fracture and non-union of the olecranon in total elbow arthroplasty. J Shoulder Elbow Surg 15:486–494PubMedCrossRefGoogle Scholar
  4. 4.
    Pooley J, Singh R (2000) Elbow arthroplasty. A guide for orthopaedic surgeons using the iBP elbow system. BiometGoogle Scholar
  5. 5.
    Amirfeyz R, Blewitt N (2009) Midterm outcome of GSB-III total elbow arthroplasty in patients with rheumatoid arthritis and patients with post-traumatic arthritis. Arch Orthop Trauma Surg 129:1505–1510PubMedCrossRefGoogle Scholar
  6. 6.
    Van Gorder GW (1940) Surgical approach in supracondylar T fractures of the humerus requiring open reduction. J Bone Joint Surg [Am] 22:278–292Google Scholar
  7. 7.
    Bryan RS, Morrey BF (1982) Extensive posterior exposure of the elbow. A triceps-sparing approach. Clin Orthop Relat Res 166:188–192PubMedGoogle Scholar
  8. 8.
    MacAusland WR (1915) Ankylosis of the elbow, with report of four cases treated by arthroplasty. JAMA 64:312–318Google Scholar
  9. 9.
    Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM (2003) Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 17:38–47PubMedCrossRefGoogle Scholar
  10. 10.
    Lehtinen JT, Kaarela K, Ikävalko M, Kauppi MJ, Belt EA, Kuusela PP, Kautiainen HJ, Lehto MU (2001) Incidence of elbow involvement in rheumatoid arthritis. A 15 year end point study. J Rheumatol 28:70–74PubMedGoogle Scholar
  11. 11.
    Skytta ET, Eskelinen A, Paavolainen P, Ikavalko M, Remes V (2009) Total elbow arthroplasty in rheumatoid arthritis. Acta Orthop 1:1–6Google Scholar
  12. 12.
    Wilkinson JM, Stanley D (2001) Posterior syrgical approaches to the elbow: a comparative anatomic study. J Shoulder Elbow Surg 10:380–382PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Rouin Amirfeyz
    • 1
    Email author
  • Damian Clark
    • 2
  • Tom Quick
    • 1
  • Neil Blewitt
    • 3
  1. 1.Trauma and Orthopaedics DepartmentBristol Royal InfirmaryBristolUK
  2. 2.Trauma and Orthopaedics DepartmentMusgrove Park HospitalTauntonUK
  3. 3.Southmead HospitalBristolUK

Personalised recommendations