The modern historical development of the surgical approaches to the elbow began with the lateral J approach to the elbow that Theodor Kocher described in his book Textbook of Operative Surgery37 published in 1911. Subsequently, many authors, such as Campbell,38 Van Gorder,39 Molesworth,40 Henry,41 MacAusland,42 Bryan and Morrey,43 Morrey and associates,44-48 and, more recently, Patterson, Bain, and Mehta,49 have described approaches to the elbow. The surgical approaches to the el-
FIGURE 1.15. Bony morphology of the elbow joint. (A) The joint line is 2 cm distal to the surface markings from the line joining the medial and lateral epicondyles. (B) In extension, the olecranon can be palpated in line with the medial and lateral epicondyles, and (C) in flexion, the three points form an isosceles triangle. (D) Anterior view of the trochlear notch and coronoid process. (E) Anterior view of the capitellum and trochlea. (F) Medial view of trochlear surfaces. (G) Lateral view of trochlear notch and radial notch.
bow can be classified into posterior,11'12'38'39'42'43,50-53 lateral,37,54-56 medial'3840 combined medial and lateral'49 and anterior41 approaches (Table 1.2). Figure 1.16 shows a cross section through the elbow that will help the surgeon to develop an understanding of the named surgical approaches used to treat various disorders. Table 1.3 lists our preferred surgical approaches and their indications.
For major elbow surgery, we place the patient in the lateral decubitus position on a vacuum suction beanbag. We apply an autoclavable, removable tourniquet above the patient's elbow with the arm positioned on a cushioned support. The elbow can be extended easily. With gravity, the elbow flexes to 90°.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.