Bryan R S, Morrey B F
Clin Orthop Relat Res. 1982 Jun(166):188-92.
Difficulty with triceps avulsion or loss of continuity after total elbow arthroplasty has prompted the development of a modified posterior approach to the elbow joint. The characteristic feature of this approach is that the triceps mechanism is reflected from medial to lateral in continuity with the forearm fascia and the olecranon and ulnar periosteum. A variant of the technique reflects the extensor mechanism from lateral to medial. The ulnar collateral ligament may be released from the humerus to provide more exposure, but the ligament must then be securely reattached. This approach, which provides extensive exposure to the elbow joint, has been employed in 49 consecutive total elbow arthroplasties and results show no loss of triceps function and no significant weakness. The approach has proved useful for treatment of intra-articular fractures of the distal end of the humerus and with synovectomy in the rheumatoid arthritic patient.
全肘关节置换术后肱三头肌撕脱或连续性丧失的问题促使人们开发了一种改良的肘关节后入路。该入路的特点是肱三头肌机制从前臂筋膜、鹰嘴和尺骨骨膜连续处从内侧向外侧翻转。该技术的一个变体是将伸肌机制从外侧向内侧翻转。尺侧副韧带可从肱骨上松解以提供更多暴露，但之后必须牢固地重新附着。这种入路可广泛暴露肘关节，已应用于连续49例全肘关节置换术，结果显示肱三头肌功能无丧失且无明显无力。该入路已被证明对治疗肱骨远端关节内骨折以及类风湿性关节炎患者的滑膜切除术有用。
