Elbow

Place the patient in the lateral decubitus position. Place the limb over an arm rest.

 Make a slightly radially curved posterior incision in the midline of the limb extending from 7 cm distal to the tip of the olecranon to 10 cm proximal to it.  Identify the ulnar nerve proximally at the medial border of the medial head of the triceps and dissect it free from its tunnel distally to its first motor branch.

Expose the olecranon & perform a chevron osteotomy with a sharp oscillating saw, braking the articular surface with a sharp osteotome

Extensive Posterior - BRYAN AND MORREY      [Back To Top] 

• A  modified posterior approach to the elbow joint .
• Provides excellent exposure and preserves the continuity of the triceps mechanism, which allows easy repair and rapid rehabilitation.
• Useful for Elbow Arthroplasty.
• Lateral decubitus position, as above.
• Posterior incision in the midline of the limb extending from 7 cm distal to the tip of the olecranon to 9 cm proximal to it.
• Identify the ulnar nerve proximally at the medial border of the medial head of the triceps and dissect it free from its tunnel distally
• The nerve is usually transposed anteriorly for arthroplasty surgery.

• Elevate the medial aspect of the triceps from the humerus, along the intermuscular septum, to the level of the posterior capsule.

• Incise the superficial fascia of the forearm distally for about 6 cm to the periosteum of the medial aspect of the olecranon.
• Carefully reflect as a single unit the periosteum and fascia from medial to lateral.
• The medial part of the junction between the triceps insertion and the superficial fascia and the periosteum of the ulna is the weakest portion of the reflected tissue. Take care to maintain continuity of the triceps mechanism at this point
• Carefully dissect the triceps tendon from the
  
  This is a preview of the site content. To view the full text for this site, you need to log in.
  If you are having problems logging in, please refer to the login help page.