Bates Taylor, Lynch Thomas B, Achay Jennifer, Powers Robert, Sabbag Casey M, Plucknette Benjamin F, Wilson David
Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX; and.
Center for Emergency Health Sciences, Spring Branch, TX.
J Orthop Trauma. 2023 Feb 1;37(2):e63-e67. doi: 10.1097/BOT.0000000000002479.
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.
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.
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.
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.
比较采用尺侧腕屈肌（FCU）劈开入路与经尺神经转位改良的泰勒-沙姆入路时，冠状突、前内侧小面和内侧副韧带前束的暴露情况。
采用随机交叉设计和标准化切口，在15具新鲜尸体上进行了30次入路操作。评估对关键解剖标志的显露情况，并从外科医生对每种入路的最佳视角拍摄校准后的数字图像。使用ImageJ（美国国立卫生研究院）软件分析图像，以计算骨暴露面积。
两种入路均能显露所有关键解剖标志。泰勒-沙姆入路的平均暴露面积为19.5平方厘米，而FCU劈开入路为13.6平方厘米（P < 0.0001）。FCU劈开入路的远端范围受尺神经及其至FCU肱骨头分支的限制。
与FCU劈开入路相比，泰勒-沙姆入路能更广泛地显露冠状突前内侧和尺骨近端，同时避免尺神经的交叉张力。
