A Triceps Split Approach for Total Elbow Arthroplasty

Total elbow arthroplasty can be performed through a variety of surgical approaches including partial or complete triceps detachment and triceps sparing. The choice is partially influenced by surgeon preference as well as patient-related and prosthetic-related factors. Failure of triceps repair is a known complication of approaches involving triceps detachment and ulnar component malposition is a common complication of triceps sparing techniques. Our approach allows total elbow arthroplasty to be performed without compromise to the triceps insertion and ideal placement of the ulnar component. In our approach the triceps split ends distally at its insertion onto the olecranon and the creation of the trough at the base of the trochlear ridge allowing for placement of the ulnar component in line with the medullary canal. This technique preserves the triceps insertion in its entirety and allows for ideal placement of the ulnar component. These factors permit rapid advancement of the postoperative rehabilitation program without placing excessive stress on the triceps insertion.