THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION

S. Foliaki; P. Poon

doi:10.1302/0301-620X.93BSUPP_III.0930379d

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THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION

S. Foliaki
P. Poon

THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION

Foliaki S, Poon P. THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION. Orthop Procs. 2011;93-B(SUPP_III):379-380. doi:10.1302/0301-620X.93BSUPP_III.0930379d

Foliaki, S., and P. Poon. “THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION.” Orthopaedic Proceedings, vol. 93-B, no. SUPP_III, 2011, pp. 379-380., https://doi.org/10.1302/0301-620X.93BSUPP_III.0930379d

Foliaki, S., & Poon, P. (2011). THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION. Orthopaedic Proceedings, 93-B(SUPP_III), 379-380. https://doi.org/10.1302/0301-620X.93BSUPP_III.0930379d

Foliaki, S. and Poon, P. (2011) “THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION.” Orthopaedic Proceedings, 93-B(SUPP_III), pp. 379-380. Available at: https://doi.org/10.1302/0301-620X.93BSUPP_III.0930379d

Foliaki, S., and P. Poon. “THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION.” Orthopaedic Proceedings 93-B, no. SUPP_III (2011): 379-380. https://doi.org/10.1302/0301-620X.93BSUPP_III.0930379d

Foliaki S, Poon P. THE TRICEPS SPLIT AND SNIP APPROACH (OXFORD APPROACH) FOR TOTAL ELBOW ARTHROPLASTY. THE APPROACH AND ITS BIOMECHANICAL EVALUATION. Orthop Procs. 2011 Jul 1;93-B(SUPP_III):379-380. https://doi.org/10.1302/0301-620X.93BSUPP_III.0930379d

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Abstract

Total elbow arthroplasty is usually performed through a posterior approach. The management of the triceps tendon insertion include; Triceps division (V-Y Triceps turn down), Detachment of the Triceps insertion either by triceps splitting (Gschwind approach) or triceps reflecting (Bryan-Morrey approach), or by leaving the Triceps insertion intact (Triceps On approach). The ideal approach needs to meet three broad criteria; firstly it should be quick and easy, secondly it should offer excellent exposure and thirdly it should have low morbidity to the Triceps tendon. An approach that is also versatile provides an additional advantage.

The purpose of this study was to present and discuss the surgical technique of a “new” posterior approach to the elbow. To biomechanically evaluate and compare the strength of the Triceps tendon repair with the Bryan-Morrey approach (recently demonstrated in a cadaveric study to be the strongest of three methods of management of the Triceps tendon).

The Bryan-Morrey and Oxford approach were each performed on fourteen pairs of cadaveric elbows with the two Triceps tendon repairs carried out. The contra-lateral elbow served as the control. The specimens were then mounted on a material testing system and a constant velocity elongation was applied.

This new approach demonstrated a significant reduction in operative time as well as providing excellent exposure suitable for multiple indications. Final analysis of the data using % ultimate strength loss (%USL) compared to the control specimens as the ultimate end point showed this new approach is as strong as the Bryan-Morrey approach with %USL of −40% for both approaches.

Correspondence should be addressed to: Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.