This technique article reviews the deep posterior surgical approaches to the elbow through a single posterior skin incision. It frames every approach around one decision: how to manage the triceps mechanism. Morrey summarizes four options and their indications, advantages, and pitfalls.
When you plan any posterior elbow operation, the first decision is how to handle the triceps, and this paper gives you the menu. For total elbow arthroplasty, the Bryan–Morrey triceps-sparing reflection from medial to lateral is the reference approach, and it obligates ulnar nerve transposition.
For a distal humeral intra-articular fracture, olecranon osteotomy gives the widest exposure, but remember two things: cut through the bare area to spare articular cartilage, and know you are sacrificing the anconeus for any future reconstruction. A practical pearl worth carrying: place the skin incision medial to the olecranon tip to protect wound healing.
Avoid the transverse triceps release entirely, since it fails with early motion. Matching the approach to the pathology, and understanding what each one costs you downstream, is exactly the judgment tested on elbow exposure questions.
This technique article reviews the deep posterior surgical approaches to the elbow through a single posterior skin incision. It frames every approach around one decision: how to manage the triceps mechanism. Morrey summarizes four options and their indications, advantages, and pitfalls.
When you plan any posterior elbow operation, the first decision is how to handle the triceps, and this paper gives you the menu. For total elbow arthroplasty, the Bryan–Morrey triceps-sparing reflection from medial to lateral is the reference approach, and it obligates ulnar nerve transposition.
For a distal humeral intra-articular fracture, olecranon osteotomy gives the widest exposure, but remember two things: cut through the bare area to spare articular cartilage, and know you are sacrificing the anconeus for any future reconstruction. A practical pearl worth carrying: place the skin incision medial to the olecranon tip to protect wound healing.
Avoid the transverse triceps release entirely, since it fails with early motion. Matching the approach to the pathology, and understanding what each one costs you downstream, is exactly the judgment tested on elbow exposure questions.