- See:
Kocher Approach to Elbow:
- Discussion:
- allows exposure of lateral column (for
condylar frx),
capitellum, and
radial head,
- it can also be used for
Monteggia frx as well as for exposure for
PIN decompression;
- lateral approach is not optimal for complex low fractures of both columns (such as the
transcondylar frx) of the distal end of the humerus;
-
interneural interval;
- between
EDC and
ECRB, which is the same interval used in the
Thompson approach to the forearm;
- because the direct lateral approach may injure the
PIN, some consider the
Kocher Approach to be safer, since it affords protection to the PIN by
going between the
aconeus and the
ECU;
- Surgical Technique:
- pt is placed in lateral or prone position;
- make longitudinal incision proximal to lateral epicondyle which is extended distally across the radio-humeral interval;
- the dissection is carried down between the ECRB and
EDC;
- or alternatively, dissect between
EDC and
ECRL;
- this dissection will expose the
supinator muscle;
- detach the humeral and ulnar heads of the supinator to expose the annular ligament;
- when this approach is extended distally, identify
PIN as it passes through
supinator muscle;
- forearm may be kept pronated case inorder to move the radial nerve away from the plane of dissection;
The lateral approach for operative release of post-traumatic contracture of the elbow.
