Elbow Disarticulation
General
- excellent level because broad flare of humeral condyles can be firmly grasped by prosthetic socket & humeral rotation can be transmitted to prosthesis
- preferable ot more proximal rotation
Technique
- equal anterior & posterior skin flaps
- beginning proximally at level of epicondyles & extending posteriorly to 2.5cm distal to olecranon & anteriorly just distal to insertion of biceps tendon
- start medially & divide
- lacertus fibrosus
- free flexor origin
- expose NV bundle medial to biceps
- proximal to joint isolate/ligate/divide brachial artery
- divide median nerve
- sharply so it retracts at least 2.5cm proximal to joint
- divide for ulnar nerve
- release biceps & brachialis distally
- divide radial nerve
- identify radial nerve between brachialis & brachioradialis & divide sharply
- posteriorly 6.3cm distal to joint
- divide extensors transversely & reflect proximally
- divide triceps tendon near tip of olecranon,
- divide anterior capsule & remove forearm
- bring triceps tendon anteriorly & suture to tendons of biceps & brachialis,
- bring flap of extensors left attached to lateral epicondyle medially
- suture to remnants of flexor mass at medial epicondyle
- ensure all bony prominences & tendons covered
- insert drain deep to fascia
- skin edges with interrupted nonabsorbable sutures
Share This Page with Your Peers and Friends
