The Anconeus Approach is Safe and Effective for Lateral Elbow Trauma: A Consecutive Case Series of Clinical and Functional Outcomes

PURPOSE To report on the clinical, functional, and radiographic outcomes after treatment of lateral elbow trauma using the anconeus approach. METHODS: Design Single-surgeon, retrospective case series Setting Academic Level-I trauma center Patients Consecutive adult patients with radial head fractures, capitellum fractures, elbow fracture-dislocations, or olecranon fracture-dislocations who underwent treatment using the anconeus approach between 2016-2021. Outcome Measures Functional outcomes evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Clinical outcomes evaluated for elbow/forearm range of motion (ROM), posterolateral rotatory instability (PLRI), and complications. Radiographic outcomes assessed with radiographs. RESULTS Nineteen patients met inclusion criteria. The mean age was 43.2 years (21-71) and 10/19 (52.6%) were male. Mean clinical follow-up was 11.9 months (range 3 to 25 months) and functional outcomes follow-up was 12.3 months (range 4 to 25 months). Mean DASH score was 9.1 (range 0.0 to 29.3). Mean elbow ROM was 112 degrees (range 60 to 140 degrees) and mean forearm pronation-supination arc was 174 degrees (range 130 to 180 degrees). No cases of synostosis, ankylosis, PLRI, or recurrent elbow dislocation were seen. Osteoarthritic changes were absent in eleven elbows, mild in seven and moderate in one. One patient developed nonunion of a radial head fracture. One patient underwent elective proximal ulna plate removal. There were no infections or cases of delayed wound healing. No patient had iatrogenic injury to the posterior interosseous nerve. CONCLUSIONS The anconeus approach is safe and effective. It resulted in excellent outcomes with a low rate of complications. It does not seem to contribute to iatrogenic PLRI.