Advertisement

Surgical Exposures of the Elbow Joint

  • Gregory BainEmail author
  • Janak A. Mehta
  • Tendai Mwaturura
Chapter

Abstract

The elbow is a relatively superficial joint where readily palpable bony prominences provide a “road map” to the underlying anatomy. Major neurovascular structures traverse the joint, and knowledge of the paths that they take around it is pivotal to gaining safe access to the area of pathology to be addressed. In this chapter, we will outline multiple approaches, posterior, lateral, medial, and anterior, and variations thereof, providing the surgeon with the knowledge required to work through 360° around the joint.

Keywords

Elbow Surgery Posterior Lateral Medial Anterior approach 

Supplementary material

Video 9.1

Hotchkiss approach (M4V 63858 kb)

References

  1. 1.
    Boyd HB. Surgical exposure of the ulna and proximal third of the radius through one incision. Surg Gynecol Obstet. 1940;71:86–8.Google Scholar
  2. 2.
    Campbell WC. Incision for exposure of the elbow joint. Am J Surg. 1932;15:65–7.CrossRefGoogle Scholar
  3. 3.
    Van Gorder GW. Surgical approach in supracondylar “T” fractures of the humerus requiring open reduction. J Bone Joint Surg. 1940;22:278–92.Google Scholar
  4. 4.
    MacAusland WR. Ankylosis of the elbow: with report of four cases treated by arthroplasty. JAMA. 1915;64:312–8.CrossRefGoogle Scholar
  5. 5.
    Bryan RS, Morrey BF. Extensive posterior exposure of the elbow. A triceps-sparing approach. Clin Orthop. 1982;166:188–92.Google Scholar
  6. 6.
    Alonso-Llames M. Bilaterotricipital approach to the elbow. Its application in the osteosynthesis of supracondylar fractures of the humerus in children. Acta Orthop Scand. 1972;43:479–90.CrossRefGoogle Scholar
  7. 7.
    Henry AK. Extensile exposure. 3rd ed. Edinburgh: Churchill Livingstone; 1995. p. 95–107.Google Scholar
  8. 8.
    Kocher T. Textbook of operative surgery. 3rd ed. London: Adam and Charles Black; 1911. p. 314–9.Google Scholar
  9. 9.
    Kaplan EB. Surgical approach to the proximal end of the radius and its use in fractures of the head and neck of the radius. J Bone Joint Surg. 1941;23:86–92.Google Scholar
  10. 10.
    Molesworth HWL. An operation for the complete exposure of the elbow-joint. Br J Surg. 1930;18:303–7.CrossRefGoogle Scholar
  11. 11.
    Pearl RM, Johnson D. The vascular supply to the skin: an anatomical and physiological reappraisal—Part I. Ann Plast Surg. 1983;11:99–105.CrossRefGoogle Scholar
  12. 12.
    Dowdy PA, Bain GI, King GJW, et al. The midline posterior elbow incision. An anatomical appraisal. J Bone Joint Surg. 1995;77B:696–9.CrossRefGoogle Scholar
  13. 13.
    Patterson SD, Bain GI, Mehta JA. Surgical approaches to the elbow. Clin Orthop. 2000;370:19–33.CrossRefGoogle Scholar
  14. 14.
    Zumstein MA, Burki A, Massy AS, Zysset P, Moor BK. Extra-articular step osteotomy of the olecranon: a biomechanical assessment. Clin Biomech (Bristol, Avon). 2015;30(10):1043–8.  https://doi.org/10.1016/j.Clinbiomech.2015.09.009.CrossRefGoogle Scholar
  15. 15.
    Gschwend N, Simmen BR, Matejovsky Z. Late complications in elbow arthroplasty. J Shoulder Elbow Surg. 1996;5:86–96.CrossRefGoogle Scholar
  16. 16.
    Studer A, Athwal GS, MacDermid JC, Faber K, King GJW. The lateral para-olecranon approach for total elbow arthroplasty. J Hand Surg. 2013;38A:2219–26.CrossRefGoogle Scholar
  17. 17.
    Gordon ML. Monteggia fracture. A combined surgical approach employing a single lateral incision. Clin Orthop. 1967;50:87–93.CrossRefGoogle Scholar
  18. 18.
    Hotchkiss RN, Kasparyan NG. The medial “over the top” approach to the elbow. Tech Orthop. 2000;15(2):105–12.CrossRefGoogle Scholar
  19. 19.
    Jobe FW. Surgical anatomy of the elbow. In: Jobe FW, editor. Operative techniques in upper extremity sports injuries. St. Louis, MO: CV Mosby; 1996. p. 405.Google Scholar

Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Gregory Bain
    • 1
    Email author
  • Janak A. Mehta
    • 2
  • Tendai Mwaturura
    • 1
  1. 1.Department of Orthopaedic Surgery and TraumaFlinders Medical Centre, Flinders UniversityAdelaideAustralia
  2. 2.Department of Orthopaedic and Trauma SurgeryRoyal Darwin HospitalDarwinAustralia

Personalised recommendations