Increased articular exposure of the lateral elbow joint with the anconeus approach compared to the Kocher approach: a cadaver study

Open Reduction and Internal Fixation of a Type IV Capitellum Fracture Through a Transolecranon Tunnel

“…Although this is a posterior skin incision/approach, it affords greater exposure of the capitellum, an anterior structure, than the Kocher approach. Cutler et al 9 found that it exposed 2.9 times more articular surface area compared with the standard Kocher approach. Landrum et al 11 reported that the anconeus approach for terrible triad injuries and capitellum fractures led to low complication rates and comparable early results with other published series.…”

“…A nonsterile tourniquet was applied to the proximal arm, and the operative extremity was prepared and draped in the usual sterile fashion. The anconeus approach, as described by Cutler et al 9 , was used to provide optimal exposure of the fracture. A posterior midline incision was made, and a full-thickness flap was raised laterally to allow exposure from the lateral epicondyle to the distal extent of the anconeus muscle.…”

“…Various surgical approaches for fixation of elbow fractures have been described 8 . The Kocher approach is considered to be the workhorse for lateral elbow surgery, but its utility for distal coronal shear fractures of the articular surface is limited because of the anterior and medial nature of these injuries 9 . We describe the management of a type IV capitellum fracture using the anconeus approach and a novel transolecranon tunnel to enable screw fixation of the lateral trochlea.…”

Internal Joint Stabilizer: A Safe Treatment for Traumatic Elbow Instability

“…Exposure was established through the anconeus approach to the elbow. 13,14 Coronoid and/or radial head injuries were then addressed. Elbow instability was then assessed under fluoroscopy.…”