Purpose
Olecranon osteotomy is commonly used to obtain access to the distal humerus for fracture
fixation. The goal of this study was to accurately describe the anatomy of the bare
area to minimize articular cartilage damage while performing olecranon osteotomies.
Methods
Twenty cadaveric ulnae were denuded to expose the bare area. Laser surface mapping
was used to create 3-dimensional models, and the nonarticular portions of the ulnae
were digitally measured.
Results
The morphology of the bare area from all aspects of the proximal ulna was defined.
The central bare area was consistent in its location, 4.9 ± 1.5 mm distal to the deepest
portion of the trochlear notch and 23.2 ± 2.3 mm distal to the olecranon tip. The
maximum chevron osteotomy apical angle to stay within the bare area averaged 110°
± 11.8°. However, there was little tolerance for error without the risk of violating
the articular cartilage. With transverse osteotomy, averaging 18° ± 10.6° in the coronal
plane, there is less risk of damaging the articular cartilage.
Conclusions
Transverse osteotomy perpendicular to the posterior surface of the ulna aiming at
the visible bare area on the medial and lateral sides of the greater sigmoid notch
may reduce the chances of violating the nonvisible articular cartilage of the proximal
ulna. Based on the findings of this study, if chevron osteotomy is used, a shallow
apex distal angle of more than 110° is recommended.
Clinical relevance
This study provides intraoperative landmarks to guide surgeons performing olecranon
osteotomies to stay within the bare area.
Key words
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Article info
Publication history
Published online: September 26, 2022
Accepted:
July 20,
2022
Received:
April 22,
2020
Publication stage
In Press Corrected ProofFootnotes
Dr King has financial involvement from Stryker Consultant. No benefits in any form have been received or will be received by the other authors related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
