Abstract
Aim
The aim of the current study was to assess the amount of the distal humerus articular surface exposed through the Newcastle approach, a posterior triceps preserving exposure of the elbow joint.
Method
Twenty-four cadaveric elbows (12 pairs) were randomized to receive one of the four posterior surgical approaches: triceps reflecting, triceps splitting, olecranon osteotomy and Newcastle approach. The ratio of the articular surface exposed for each elbow was calculated and compared.
Results
The highest ratio observed was for Newcastle approach (0.75 ± 0.12) followed by olecranon osteotomy (0.51 ± 0.1), triceps reflecting (0.37 ± 0.08) and triceps splitting (0.35 ± 0.07). The differences between Newcastle approach and other approaches were statistically significant (p = 0.003 vs. osteotomy and <0.0001 vs. triceps reflecting and splitting).
Conclusion
The Newcastle approach sufficiently exposes the distal humerus for arthroplasty or fracture fixation purposes. Its use is supported by the current study.
Similar content being viewed by others
References
Patterson SD, Bain GI, Mehta JA (2000) Surgical approaches to the elbow. Clin Orthop Relat Res 370:19–33
Celli A, Arash A, Adams RA, Morrey BF (2005) Triceps insufficiency following total elbow arthroplasty. J Bone Joint Surg [Am] 87:1957–1964
Marra G, Morrey BF, Gallay SH, McKee MD, O’Driscoll S (2006) Fracture and non-union of the olecranon in total elbow arthroplasty. J Shoulder Elbow Surg 15:486–494
Pooley J, Singh R (2000) Elbow arthroplasty. A guide for orthopaedic surgeons using the iBP elbow system. Biomet
Amirfeyz R, Blewitt N (2009) Midterm outcome of GSB-III total elbow arthroplasty in patients with rheumatoid arthritis and patients with post-traumatic arthritis. Arch Orthop Trauma Surg 129:1505–1510
Van Gorder GW (1940) Surgical approach in supracondylar T fractures of the humerus requiring open reduction. J Bone Joint Surg [Am] 22:278–292
Bryan RS, Morrey BF (1982) Extensive posterior exposure of the elbow. A triceps-sparing approach. Clin Orthop Relat Res 166:188–192
MacAusland WR (1915) Ankylosis of the elbow, with report of four cases treated by arthroplasty. JAMA 64:312–318
Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM (2003) Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 17:38–47
Lehtinen JT, Kaarela K, Ikävalko M, Kauppi MJ, Belt EA, Kuusela PP, Kautiainen HJ, Lehto MU (2001) Incidence of elbow involvement in rheumatoid arthritis. A 15 year end point study. J Rheumatol 28:70–74
Skytta ET, Eskelinen A, Paavolainen P, Ikavalko M, Remes V (2009) Total elbow arthroplasty in rheumatoid arthritis. Acta Orthop 1:1–6
Wilkinson JM, Stanley D (2001) Posterior syrgical approaches to the elbow: a comparative anatomic study. J Shoulder Elbow Surg 10:380–382
Acknowledgments
The authors would like to thank Mr. Joe Pooley for his support and teachings.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Amirfeyz, R., Clark, D., Quick, T. et al. Newcastle approach to the elbow, a cadaveric study. Arch Orthop Trauma Surg 131, 747–751 (2011). https://doi.org/10.1007/s00402-010-1206-0
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-010-1206-0