Master Tech Ortho Surgery Elbow CH1

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1  Exposures of the Upper Extremity: Humerus, Elbow, Forearm

FIGURE 1B-25

Distal Extension Landmarks  The lateral epicondyle, posterior border of the extensor carpi ulnaris, anterior edge of the anconeus, and the crista supinatoris. The anconeus is elevated from the ulna exposing the attachment site of the LUCL at the tubercle of the supinator (Fig. 1B-26).

Extensile Posterior Lateral Exposure (Kocher) Note : We have found that the described surgical exposures to the elbow are sufficient for virtually all reconstructive procedures, and all may be executed through a posterior skin incision. The classic extensile approach described by Kocher implies that the anterior capsule has been incised and the lateral collateral ligament has been released (4). Indications  Reconstructive procedures, including open reduction internal fixation, total elbow arthroplasty (unlinked), and interposition arthroplasty. FIGURE 1B-26 For a more detailed exposure of the lateral ligament complex, the anconeus is reflected posterior from its ulnar insertion.

Landmarks  The proximal lateral column and the distal Kocher interval. Position  Supine, arm across the chest.