Digastric olecranon osteotomy: feasibility study of a new approach to the elbow

Abstract

None of the multiple posterior approaches to the elbow simultaneously satisfies the following three properties: good articular surface exposure, attention to the extensor apparatus continuity and olecranon vascularization. This study aims to describe a new approach to the elbow: digastric olecranon osteotomy. Nine anatomical subjects were prepared. One-third underwent intra-articular digastric osteotomy, one-third extra-articular osteotomy and one-third a vascularization study using arteriography. Digastric olecranon osteotomy, notably intra-articular, offered excellent articular exposure. After restoration, digastric stability was excellent. Olecranon vascularization was preserved using the two variations of digastric olecranon osteotomy. Digastric olecranon osteotomy preserves the principal vascular supply of the olecranon and the continuity of the extensor apparatus. Articular surface exposure is excellent, and the natural coaptation of the digastric enables immediate mobilization without any theoretical risk of deconstruction.