Open approaches to the lateral elbow: surgical indications, anatomic considerations, and technical pearls

Abstract

Several lateral approaches to the lateral elbow have been described for management of a variety of elbow pathologies, and each poses unique technical challenges given the complexity of surrounding neurologic, vascular, and ligamentous anatomy. This article reviews 6 common lateral elbow approaches—the Kaplan, modified Kocher, extensor digitorum communis splitting, extensor digitorum communis splitting with proximal extension, lateral column, and lateral epicondyle osteotomy—and outlines the relevant surgical indications, anatomic considerations, and operative steps for each with illustrative examples provided using cadaveric dissections. Pearls and pitfalls and technical tips and tricks will hopefully be useful for the practicing orthopedic surgeon.