Barnes Leslie Fink, Lombardi Joseph, Gardner Thomas R, Strauch Robert J, Rosenwasser Melvin P
1 Temple University, Philadelphia, PA, USA.
2 Columbia University, New York City, NY, USA.
Hand (N Y). 2019 Mar;14(2):253-258. doi: 10.1177/1558944717745662. Epub 2018 Jan 22.
The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes.
Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer. Six measurements were taken for each approach by 2 surgeons, and the mean of these measurements were analyzed.
The mean surface area visible with the lateral collateral ligament (LCL) preserved in the Kaplan approach was 616.6 mm in comparison with the surface area of 136.2 mm visible in the Kocher approach when the LCL was preserved. Using a 2-way analysis of variance, the difference between these 2 approaches was statistically significant. When the LCL complex was incised in the Kocher approach, the average visible surface area of the Kocher approach was 456.1 mm and was statistically less than the Kaplan approach. The average surface area of the coronoid visible using a proximally extended Kaplan approach was 197.8 mm.
The Kaplan approach affords significantly greater visible surface area of the proximal radius than the Kocher approach.
本研究的目的是比较在外侧肘部的 Kaplan 入路和 Kocher 入路中桡骨头、颈部和冠突的完整可见表面积。假设是由于肌间平面的解剖差异，Kaplan 入路将提供更大的视野。
对 10 具尸体采用 Kaplan 入路和 Kocher 入路进行解剖，并使用三维数字化仪原位测量可见表面积。由 2 名外科医生对每种入路进行 6 次测量，并对这些测量值的平均值进行分析。
在 Kaplan 入路中保留外侧副韧带（LCL）时可见的平均表面积为 616.6 mm，而在 Kocher 入路中保留 LCL 时可见的表面积为 136.2 mm。使用双向方差分析，这两种入路之间的差异具有统计学意义。当在 Kocher 入路中切开 LCL 复合体时，Kocher 入路的平均可见表面积为 456.1 mm，在统计学上小于 Kaplan 入路。使用近端扩展的 Kaplan 入路可见的冠突平均表面积为 197.8 mm。
与 Kocher 入路相比，Kaplan 入路能提供明显更大的近端桡骨可见表面积。
