Master Tech Ortho Surgery Elbow CH1

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PART I Exposures

FIGURE 1B-43 The forearm fascia and ulnar periosteum have been elevated from the ulna distally and the triceps from the posterior aspect of the humerus proximally, and the insertion in the triceps is further reflected from its insertion into the tip of the olecranon. Further reflection laterally allows identification of the anconeus, which is elevated from its ulnar insertion.

Tips/Pitfalls/Comments  For linked total elbow arthroplasty, the lateral and medial collateral ligaments are released and the extensor mechanism is reflected lateral to the epicondyle (Fig. 1B-44A and B). The elbow is flexed, and the tip of the olecranon is removed to expose the joint (Fig. 1B-45A and B). Note: In every instance in which the triceps has been completely reflected, it is necessary to securely reattach the insertion site to the olecranon with a crisscross type of suture.

Olecranon

Extensor mechanism

Lateral collateral ligament

Ulnar n.

B

FIGURE 1B-44