The triceps-flexor carpi ulnaris (TRIFCU) approach to the elbow.
BACKGROUND
Intra-articular fractures of the distal humerus frequently require internal fixation. Several approaches have been described, with the posterior approaches being most common. We present a new approach to the distal humerus via the lateral border of the triceps muscle.


METHODS
The senior author has used this technique for fixation of intra-articular fractures of the distal humerus in 12 patients.


RESULTS
The approach is equally useful for intra- and extra-articular fractures. No cases of postoperative ulna nerve neuropraxia have been encountered. There have been no postoperative wound complications. The exposure has allowed sufficient access to allow anatomically contoured plates to be easily applied to both sides of the distal humerus with confirmation of intra-articular fracture reduction.


CONCLUSIONS
The approach has the advantages of leaving the muscular bed of the ulna nerve undisturbed, whilst still providing excellent exposure of the distal humerus. The triceps mechanism is not divided or split allowing rapid recovery of extensor function. Additionally, because of the natural carrying angle of the elbow, repositioning of the reflected triceps aponeurosis is easy.
Deakin
D E
DE
Department of Orthopaedics, Birmingham City Hospital, Dudley Road, Birmingham B18 7QH, UK.
Deshmukh
S C
SC
D004551:Elbow Joint / Q000033:anatomy & histology / Q000294:innervation / Q000601:surgery; D000071938:Fasciotomy; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D020424:Ulnar Neuropathies / Q000517:prevention & control; D000092464:Elbow Injuries