A Preliminary Study on the Safety of Anterolateral Approach Elbow Arthroscopy / 中国微创外科杂志

ABSTRACT

Objective To evaluate the anatomic relationships between the portals and radial nerve of three different operations of antrolateral approach elbow arthroscopy.Methods The dissections were pedormed in 10 formalin soaked adult cadaver elbows.The distances from the three different antrolateral portals to the radial nerve in extension and flexion 90° position were measured.The portal A was located at 3 cm distal and 1 cm anterior to the lateral epicondyle;the portal B was located at 2 cm distal and 2 cm anterior to the lateral epicondyle;the portal C,1 cm distal and 1 cm anterior to the lateral epicondyle.Results The nearest distances from the anterolateral portal A,B,and C to the radial nerve in extension position were (2.30 ± 0.95) mm,(3.00 ± 1.56) mm,and (3.60 ± 1.65) mm,with significant differences (F =11.097,P =0.001).Statistical difference in distances from the anterolateral portal to the radial nerve between portal A and C was found (P =0.006).No statistically significant difference was seen between A and B or B and C (PA-B =0.134,PB-c =0.072).The distances from the anterolateral portal A,B,and C to the radial nerve in flexion 90° position were (4.40 ± 2.01) mm,(6.10 ± 1.79) mm,and (7.90 ± 1.85) mm,with significant differences (F =54.775,P =0.000).There were statistically significant difference among the three approaches (PA-B =0.000,PA-c =0.000,PB-c =0.002).The distances increased when the position changed from extension to flexion 90° for portal A (t =-5.161,P =0.001),portal B (t=-8.188,P=0.000),and portal C (t =-10.167,P =0.000).Conclusion The anterolateral portal 1 cm distal and 1 cm anterior to the lateral epicondyle is the safest apporach.