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. 2023 Feb 1;37(2):e63-e67.
doi: 10.1097/BOT.0000000000002479.

Medial Elbow Exposure: Modified Taylor-Scham Versus Flexor Carpi Ulnaris-Split

Taylor Bates  1 , Thomas B Lynch  1 , Jennifer Achay  2 , Robert Powers  1 , Casey M Sabbag  1 , Benjamin F Plucknette  1 , David Wilson  1
Affiliations

Medial Elbow Exposure: Modified Taylor-Scham Versus Flexor Carpi Ulnaris-Split

Taylor Bates et al. J Orthop Trauma. .

Abstract

Objective: To compare the exposure of the coronoid process, anteromedial facet, and anterior band of the medial collateral ligament using the flexor carpi ulnaris (FCU)-splitting approach with the Taylor-Scham approach modified with an ulnar nerve transposition.

Methods: Thirty approaches were performed on 15 fresh cadavers using a randomized cross-over design and standardized incision. Access to key anatomic landmarks was assessed, and a calibrated digital image was taken from the surgeon's best perspective of each approach. Images were analyzed using ImageJ (National Institutes of Health) software to calculate the area of osseous exposure.

Results: All key anatomic landmarks were visualized using both approaches. The average area of exposure for the Taylor-Scham was 19.5 cm 2 compared with 13.6 cm 2 for the FCU-splitting ( P < 0.0001). The distal extent of the FCU-splitting approach is limited by the ulnar nerve and its branches to the humeral head of the FCU.

Conclusion: The Taylor-Scham approach provides a more extensile exposure of the anteromedial coronoid and proximal ulna than the FCU-splitting approach while avoiding cross-tensioning of the ulnar nerve.

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Conflict of interest statement

The authors report no conflict of interest.

References

    1. Closkey RF, Goode JR, Kirschenbaum D, et al. The role of the coronoid process in elbow stability. A biomechanical analysis of axial loading. J Bone Joint Surg Am. 2000;82:1749–1753.
    1. O'Driscoll SW, Jupiter JB, Cohen MS, et al. Difficult elbow fractures: pearls and pitfalls. Instr Course Lect. 2003;52:113–134.
    1. Doornberg JN, Ring DC. Fracture of the anteromedial facet of the coronoid process. J Bone Joint Surg Am. 2006;88:2216–2224.
    1. Doornberg JN, Ring D. Coronoid fracture patterns. J Hand Surg. 2006;31:45–52.
    1. Hotchkiss RN, Kasparyan GN. The medial “Over the top” approach to the elbow. Tech Orthop. 2000:105–112.

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