Triceps on approach for total elbow arthroplasty: worth preserving? A review of approaches for total elbow arthroplasty

摘要

Total elbow arthroplasty can be a rewarding operation and is becoming increasingly used in the elderly fracture population. Multiple approaches are represented in the literature and deciding on the best approach is difficult. This review discusses approaches and their reported outcomes, aiming to allow surgeons to make an informed choice about which approach to use. Total elbow arthroplasty (TEA) can be a rewarding operation in the right cohort of patients,1 including painful arthritis and post trauma sequalae, and is being increasingly used for the elderly acute distal humerus fracture population.2 Multiple approaches are represented in the literature and deciding on the best approach is difficult. The triceps-on approach, where the triceps mechanism is preserved on the ulna insertion, has been gaining popularity recently. It is perceived to be more technically demanding than the triceps off approaches where the triceps mechanism is elevated off the ulna or partly cut. A good approach for TEA should allow adequate exposure to properly position the implants, have a low risk of nerve damage, achieve a good range of movement and preserve triceps function. The aim of this review is to present the current available literature in an attempt to answer whether the triceps-on approach can best fulfil these requirements.