Why Make the Cut? The Anconeus Triceps Hemipeel Approach for Distal Humerus Exposure Without Olecranon Osteotomy.

Abstract

Articular visualization is a challenging aspect of treating comminuted intraarticular distal humerus fractures (AO/OTA types 13B and 13C). Multiple surgical approaches have been described to improve articular visualization while minimizing morbidity to the patient. The anconeus hemipeel approach is a modified approach to the distal humerus involving retrograde reflection of the anconeus to provide improved exposure to the distal humerus. The anconeus hemipeel approach can be used in place of the olecranon osteotomy-which adds additional morbidity and complicates future arthroplasty options. This study describes the approach as a technical trick and reports the first clinical outcomes of patients treated with the anconeus hemipeel approach for exposure of the distal humerus without an olecranon osteotomy for the treatment of comminuted, intraarticular distal humerus fractures.