Medial Elbow Exposure for Coronoid Fractures: FCU-Split Versus Over-the-Top
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
The optimal exposure interval for anteromedial coronoid fractures is unknown. The purpose of this study was to quantitatively compare the osseous and ligamentous exposure of the medial elbow using the flexor carpi ulnaris FCU-Splitting and Hotchkiss Over-the-Top approaches. The FCU-Splitting approach provides nearly three times more osseous exposure of the anteromedial coronoid and proximal ulna than the Hotchkiss Over-the-Top approach. The FCU-Splitting approach is able to provide adequate access to anteromedial coronoid fractures, including those anterior to the sublime tubercle, as achieved with the Hotchkiss approach. Because the FCU-Splitting approach carries the additional advantages of using the natural split between the two FCU muscle heads, maintaining the native origin of the flexor-pronator mass, and avoidance of the anterior neurovascular structures, we believe this technique can be considered for most anteromedial coronoid fractures that require medial elbow exposure. Future clinical studies are needed to confirm these results and determine the true efficacy of using the FCU-Splitting approach over the Hotchkiss approach for the management of anteromedial coronoid fractures.
- Medicine and Medical Research