Objective Analysis of Lateral Elbow Exposure with the Extensor Digitorum Communis Split Compared with the Kocher Interval

Desloges, William; Louati, Hakim; Papp, Steven; Pollock, J. Whitcomb

doi:10.2106/jbjs.m.00001

Cited by 49 publications

(25 citation statements)

References 26 publications

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“…In the extended EDC splitting approach, the anterior half of the EDC and the extensor carpi radialis are detached from the supracondylar ridge. 4,5 The surgical approach proposed in our case series is a safe and valid choice for the treatment of complex radial head fractures providing with a good functional outcome. All patients reported satisfactory restoration of range of motion and we did not record in our series complications like instability (posterolateral rotatory instability or varus posteromedial instability) or infection at the last follow-up.…”

Section: Discussionmentioning

confidence: 89%

Detachment of Extensor Carpi Ulnaris and Anterior Branches of the Radial Collateral Ligament from the Epicondyle: A Modification of Kocher Lateral Approach for the Treatment of Radial Head Fractures

Touloupakis

Biancardi

Ghirardelli

et al. 2019

Joints

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Purpose The aim of this study is to present clinical results of a retrospective case series that includes patients treated with an extensive modification of the Kocher lateral approach to the elbow with surgical detachment of the anterior branches of the radial collateral ligament. Methods From January 2016 to January 2018, nine patients with closed isolated displaced or multifragmentary radial head fractures (Mason type II, III, or IV) who underwent osteosynthesis or arthroplasty through a modified Kocher lateral elbow approach were available for follow-up. Results There were six female and three male patients. The median age at the time of surgery was 52 years old (range: 26–70). The dominant upper limb was injured in 22.2% of patients. After a median follow-up of 8 (range: 6–27) months, all patients regained completely all their daily activities and no cases of infections were recorded. Conclusion We believe that the approach proposed can be a useful choice to deal with these challenging injuries. Our strategy may represent a valid alternative to more popular approaches as the use of anchors decreases the risk of instability that is the major danger considered in the past when soft tissues as tendons and ligaments are detached. Level of Evidence This is a level IV study (therapeutic case series).

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Section: Discussionmentioning

confidence: 89%

Detachment of Extensor Carpi Ulnaris and Anterior Branches of the Radial Collateral Ligament from the Epicondyle: A Modification of Kocher Lateral Approach for the Treatment of Radial Head Fractures

Touloupakis

Biancardi

Ghirardelli

et al. 2019

Joints

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“…In infections involving the elbow, a lateral incision was made, opening a gap between the anconeus and the extensor carpi ulnaris muscles (modified Kocher's access). 16 Eight patients (30%) required two or more surgeries. The median time between symptom onset and joint drainage was six days (IQR 4; 17).…”

Section: Resultsmentioning

confidence: 99%

Septic arthritis of the shoulder and elbow: one decade of epidemiological analysis at a tertiary referral hospital

Assunção

Noffs

Malavolta

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo describe the clinical and epidemiological characteristics of patients with septic arthritis of the shoulder or elbow and to evaluate prognostic factors for complications during treatment.MethodsA retrospective case series was studied with patients treated between 2004 and 2014. The patients’ clinical and epidemiological characteristics were collected. The clinical and orthopedic complications were identified and possible prognostic factors were evaluated.ResultsTwenty-seven patients were analyzed, 17 with septic arthritis of the shoulder and ten of the elbow. Median age was 46 years (IQR, 24.5; 61). Previous joint disease was observed in nine patients (33%). At least one clinical comorbidity was observed in 23 patients (85%). Staphylococcus aureus was identified in 14 cases (52%). Fourteen patients (52%) had at least one clinical complication and five patients died (19%). Nine patients (33%) had some type of orthopedic complication. The time between onset of symptoms and surgical treatment was longer in patients with orthopedic complications (p = 0.020). Regarding the development of clinical complications, leukocytosis on hospital admission time (p = 0.021) and the presence of clinical morbidities (p = 0.041) were predictive factors.ConclusionsSeptic arthritis of the shoulder and elbow primarily affects individuals who are immunocompromised and/or have clinical comorbidities. S. aureus is the most common pathogen in Brazil. Leukocytosis at hospital admission and the presence of clinical comorbidities are factors associated with the presence of clinical complications. Longer time between onset of symptoms and surgical treatment was correlated with orthopedic complications.

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“…For the surgical exposure, Desloges and Louati (2014), suggested an extended EDC approach, because it can provide a wide-angle view in a radial head fracture surgery. This is the approach used in this study.…”

Section: Discussionmentioning

confidence: 99%

Results of screw fixation in Mason type II radial head fractures

et al. 2016

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PurposeThe treatment of Mason type II fractures is controversial, and the aim of our study is to define the outcome of surgical treatment with screw fixation in the Mason type II radial head fracture.MethodsThe study was carried out between 2011 and 2015, and included 14 men and 9 women, with isolated Mason type II radial head fractures which were treated operatively with screw fixation. Cases involving the additional ligament injury or fractures in other areas, or having a follow-up period which is greater than 11 months were excluded. The clinical and radiological results of our patients were assessed, using the Mayo Elbow Performance Score (MEPS).ResultsThe average MEPS was 95.86 points. 100 degree arcs of motion were attained by a total of 21 patients (91 %) for both flexion–extension and pronation–supination. Nevertheless, 2 patients (9 %) did not recover the 100 degree arcs for the flexion–extension.ConclusionAnatomical reduction of type II radial head fractures through open surgery and fixation with screws can have favorable results.Level of evidenceLevel IV, Retrospective design.

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Objective Analysis of Lateral Elbow Exposure with the Extensor Digitorum Communis Split Compared with the Kocher Interval

Abstract: The results suggest that the EDC splitting approach provides more reliable visualization of the anterior half of the radial head while minimizing soft-tissue dissection and reducing the risk of iatrogenic injury to the lateral ulnar collateral ligament.

Cited by 49 publications

References 26 publications

Detachment of Extensor Carpi Ulnaris and Anterior Branches of the Radial Collateral Ligament from the Epicondyle: A Modification of Kocher Lateral Approach for the Treatment of Radial Head Fractures

Detachment of Extensor Carpi Ulnaris and Anterior Branches of the Radial Collateral Ligament from the Epicondyle: A Modification of Kocher Lateral Approach for the Treatment of Radial Head Fractures

Septic arthritis of the shoulder and elbow: one decade of epidemiological analysis at a tertiary referral hospital

Results of screw fixation in Mason type II radial head fractures

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