Articular Exposure between Triceps Reflecting Anconeus Pedicle (TRAP) Approach and Olecranon Osteotomy Approach

Article Sidebar

PDF
Published: Sep 20, 2019
DOI: https://doi.org/10.31524/bkkmedj.2019.09.006
Keywords:
olecranon osteotomy approach, triceps reflecting anconeus pedicle approach, TRAP, distal humerus articular exposure, elbow

Main Article Content

Kriwut Leurmprasert, MD
Chatchanin Mayurasakorn, MD
Nathapon Chantaraseno, MD
Theerachai Apivatthakakul, MD
Suthorn Bavonratanavech, MD

Abstract










OBJECTIVES: To compare percentage of articular exposure of distal humerus between triceps-reflecting anconeus pedicle (TRAP) approach and olecranon osteotomy approach.


MATERIAL AND METHODS: 10 fresh cadaveric elbows were randomly allocated into 2 groups. Group 1 (5 elbows) was assigned for olecranon osteotomy approach. Group 2 (5 elbows) was assigned for TRAP approach. After surgical exposures were done, the visible articular surface of distal humerus was painted with oil-based yellow color. Subsequently, all dissected elbows were disarticulated. The remaining invisible articular area was painted with oil-based blue color. A square mesh net was firmly wrapped around the painted articular surface. The number of squares was counted and calculated into percentage of articular exposure. Median was calculated and compared among both groups.


RESULT: The olecranon osteotomy exposure group offers median of articular exposure at 57.69%. TRAP exposure group offers 47.45% with statistical significance in the difference between two approaches (Mann-Whitney U test, p = 0.028, 95% CI = 2.1 to 15.9)


CONCLUSION: The olecranon osteotomy exposure offers more articular visualization compared with the TRAP approach with statistical significance.










Article Details

How to Cite
1.
Leurmprasert K, Mayurasakorn C, Chantaraseno N, Apivatthakakul T, Bavonratanavech S. Articular Exposure between Triceps Reflecting Anconeus Pedicle (TRAP) Approach and Olecranon Osteotomy Approach. BKK Med J [Internet]. 2019 Sep. 20 [cited 2024 Nov. 24];15(2):158. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222821
Issue
Vol. 15 No. 2 (2019): September
Section
Original Article

This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. Wilkinson JM, Stanley D. Posterior surgical approaches to the elbow: a comparative anatomic study. J Shoulder Elbow Surg 2001;10(4):380-2.
2. Dakouré PW, Ndiaye A, Ndoye JM, et al. Posterior surgical approaches to the elbow: a simple method of comparison of the articular exposure. Surg Radiol Anat2007;29(8):671-4.
3. Pollock JW, Athwal GS, Steinmann SP. Surgical exposures for distal humerus fractures: a review. Clin Anat 2008;21(8):757-68.
4. Ring D, Gulotta L, Chin K, et al. Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. J Orthop Trauma 2004;18(7):446-9.
5. O’Driscoll SW. The triceps-reflecting anconeus pedicle (TRAP) approach for distal humeral fractures and nonunions. Orthop Clin North Am 2000;31(1):91-101.
6. Özer H, Solak S, Turanli S, et al. Intercondylar fractures of the distal humerus treated with the triceps-reflecting anconeus pedicle approach. Arch Orthop Trauma Surg 2005;125(7):469-74.
7. Sachdev S, Shah K, Mehta M, et al. The comparison of triceps reflecting anconeus pedicle and olecranon osteotomy approaches in the treatment of intercondylar fractures of the humerus. Indian J Orthop Surg 2017;3(3):294-300.
8. Bryan RS, Morrey BF. Extensive posterior exposure of the elbow. A triceps-sparing approach. Clin Orthop 1982;166:188-92.
9. Van Gorder GW. Surgical approach in supracondylar “T” fractures of the humerus requiring open reduction. J Bone Joint Surg Am 1940;22:278-92.