A Modified Anteromedial Approach for Exposure of Coronoid Fractures: An Anatomical Cadaver Study

Abstract

The previous anterior approach to the elbow provides a limited exposure of the coronoid process. The aim of this study was to identify the optimal exposure interval for coronoid fractures from the anterior aspect of elbow. We exposed the coronoid process on twelve fresh-frozen cadaveric elbows from the anteromedial aspect of the elbow. The dissection intervals used were the novel brachial artery-median nerve interval (B-M interval) and the previously reported biceps tendon-brachial artery interval (B-B interval). Access to key anatomic landmarks around the coronoid process was assessed and the exposed surface area of coronoid process was calculated in each specimen. The average exposed surface area of coronoid process was 2.26 times greater with the B-M interval (4.58 cm 2 ) compared with the B-B interval (2.03 cm 2 ) (p < 0.05). All key anatomic landmarks around the coronoid process were directly visualised via the B-M interval in each specimen. In conclusion, the anteromedial approach through the B-M interval provides a more extensive exposure of the coronoid process than the traditional B-B interval. This new approach can be useful for the fixation of coronoid fractures.