{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:55:56Z","timestamp":1788177356884,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Elbow stiffness is a common reason for consultation. In recent years, arthroscopic techniques in elbow surgery have progressed, but there are still some contraindications to performance of arthroscopic synovectomy and release in this joint (elbows with anatomic deformity after multiple procedures, malunion, presence of osteosynthesis material, severe stiffness of &gt;80 degrees, instability, or previous transposition of the ulnar nerve). Therefore, knowledge of a safe and reliable open approach to achieve elbow release and\/or synovectomy is essential. We report the technical details of the modified lateral approach between extensor carpi radialis brevis and longus muscles, as well as the clinical results of 43 elbow release and\/or synovectomy procedures, illustrating its feasibility. The modified lateral approach, providing visual control of the radial nerve and good anterior exposure of the elbow joint, is detailed. From 1994 to 2016, this approach was used in 43 release and\/or synovectomy procedures of the elbow in 41 patients, 30 men and 11 women, with a mean age of 40.56 years (range, 17 to 84\u2009y). Using this procedure, 38 elbows (93%) recovered full extension and 5 subtotal extension with an average deficit of 11 degrees (range, 5 to 20 degrees). All elbows were stable. No neurological complications were reported. The modified lateral approach preserves the insertion of the lateral epicondyle muscles that are major dynamic stabilizers and reduces the risk of instability. Initially described for the treatment of radial tunnel syndrome, it should also be recommended for elbow release and synovectomy.<\/jats:p>","DOI":"10.1097\/bth.0000000000000312","type":"journal-article","created":{"date-parts":[[2020,8,30]],"date-time":"2020-08-30T18:02:07Z","timestamp":1598810527000},"page":"84-88","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Modified Lateral Approach of the Elbow for Surgical Release and Synovectomy"],"prefix":"10.1097","volume":"25","author":[{"given":"Steven","family":"Roulet","sequence":"first","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertille","family":"Charruau","sequence":"additional","affiliation":[{"name":"Department of Upper Limb and Hand Surgery, Clinique de l\u2019Essonne, Cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Mazaleyrat","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ferembach","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Marteau","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacky","family":"Laulan","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Bacle","sequence":"additional","affiliation":[{"name":"Hand Surgery Unit, Department of Orthopedic Surgery, Trousseau University Hospital, Medical University Fran\u00e7ois Rabelais of Tours, Tours"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"R1-20250512","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.jhsa.2007.09.015","article-title":"The posttraumatic stiff elbow: a review of the literature","volume":"32","author":"Lindenhovius","year":"2007","journal-title":"J Hand Surg"},{"key":"R2-20250512","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.2106\/00004623-199509000-00021","article-title":"Reconstruction for post-traumatic conditions of the elbow joint","volume":"77","author":"Modabber","year":"1995","journal-title":"J Bone Joint Surg Am"},{"key":"R3-20250512","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00776-013-0447-5","article-title":"Posttraumatic elbow contractures: targeting neuroinflammatory fibrogenic mechanisms","volume":"18","author":"Monument","year":"2013","journal-title":"J Orthop Sci"},{"key":"R4-20250512","first-page":"26","article-title":"The posttraumatic stiff elbow","volume":"431","author":"Morrey","year":"2005","journal-title":"Clin Orthop"},{"key":"R5-20250512","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2106\/00004623-198163060-00002","article-title":"A biomechanical study of normal elbow motion","volume":"63A","author":"Morrey","year":"1981","journal-title":"J Bone Joint Surg Am"},{"key":"R6-20250512","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0030-5898(05)70133-4","article-title":"Posttraumatic elbow stiffness","volume":"31","author":"King","year":"2000","journal-title":"Orthop Clin North Am"},{"key":"R7-20250512","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0278-5919(20)30132-0","article-title":"Arthroscopy of the elbow","volume":"15","author":"Baker","year":"1996","journal-title":"Clin Sports Med"},{"key":"R9-20250512","first-page":"93","article-title":"The assessment and management of the stiff elbow","volume":"52","author":"Jupiter","year":"2003","journal-title":"Instr Course Lect"},{"key":"R10-20250512","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/03635465990270022401","article-title":"Arthroscopy of the elbow","volume":"27","author":"Baker","year":"1999","journal-title":"Am J Sports Med"},{"key":"R11-20250512","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.arthro.2009.12.029","article-title":"Anteromedial elbow arthroscopy portals in patients with prior ulnar nerve transposition or subluxation","volume":"26","author":"Sahajpal","year":"2010","journal-title":"Arthroscopy"},{"key":"R12-20250512","doi-asserted-by":"crossref","first-page":"810","DOI":"10.5435\/JAAOS-22-12-810","article-title":"Elbow arthroscopy: indications, techniques, outcomes, and complications","volume":"22","author":"Adams","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"key":"R14-20250512","first-page":"86","article-title":"Surgical approaches to the proximal end of the radius and its use in fractures of the head and neck of the radius","volume":"23","author":"Kaplan","year":"1941","journal-title":"J Bone Joint Surg"},{"key":"R15-20250512","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00003086-200001000-00005","article-title":"Classification and evaluation of recurrent instability of the elbow","volume":"370","author":"O\u2019Driscoll","year":"2000","journal-title":"Clin Orthop"},{"issue":"suppl S","key":"R16-20250512","doi-asserted-by":"crossref","first-page":"179S","DOI":"10.1016\/j.jse.2004.09.032","article-title":"Soft-tissue stabilizers of the elbow","volume":"14","author":"Safran","year":"2005","journal-title":"J Shoulder Elbow Surg"},{"key":"R17-20250512","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ocl.2007.12.001","article-title":"Anatomy and biomechanics of the elbow","volume":"39","author":"Bryce","year":"2008","journal-title":"Orthop Clin North Am"},{"key":"R18-20250512","first-page":"205","article-title":"Entrapment of the posterior interosseous nerve","volume":"11","author":"Hagert","year":"1977","journal-title":"Scand J Plast Reconstr Surg"},{"key":"R19-20250512","first-page":"177","article-title":"Radial tunnel syndrome. Study of a continuous and homogenous series of 35 cases","volume":"76","author":"Raimbeau","year":"1990","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"R21-20250512","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00003086-199104000-00021","article-title":"Valgus stability of the elbow. A definition of primary and secondary constraints","volume":"265","author":"Morrey","year":"1991","journal-title":"Clin Orthop"},{"key":"R22-20250512","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1002\/jor.20845","article-title":"New rabbit knee model of posttraumatic joint contracture: indirect capsular damage induces a severe contracture","volume":"27","author":"Nesterenko","year":"2009","journal-title":"J Orthop Res"},{"key":"R23-20250512","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.jse.2006.06.018","article-title":"Structural and biochemical evaluation of the elbow capsule after trauma","volume":"16","author":"Cohen","year":"2007","journal-title":"J Shoulder Elbow Surg"},{"key":"R24-20250512","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/17453670710014860","article-title":"Cellular, matrix, and growth factor components of the joint capsule are modified early in the process of posttraumatic contracture formation in a rabbit model","volume":"79","author":"Hildebrand","year":"2008","journal-title":"Acta Orthop"},{"key":"R25-20250512","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1016\/j.main.2004.10.006","article-title":"Compressions du nerf radial au coude","volume":"23","author":"Raimbeau","year":"2004","journal-title":"Chir Main"},{"key":"R26-20250512","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/BF01629856","article-title":"Anatomic basis of the physiopathology of the epicondylagias: a study of the deep branch of the radial nerve","volume":"15","author":"Rath","year":"1993","journal-title":"Surg Radiol Anat"},{"key":"R27-20250512","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/0363-5023(91)90205-P","article-title":"Radial nerve entrapment at the elbow: surgical anatomy","volume":"16A","author":"Fuss","year":"1991","journal-title":"J Hand Surg"},{"key":"R28-20250512","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0363-5023(79)80105-7","article-title":"The radial tunnel syndrome","volume":"4","author":"Lister","year":"1979","journal-title":"J Hand Surg"},{"key":"R29-20250512","first-page":"366","article-title":"Les rapports du muscle court extenseur radial du carpe avec la branche de division profonde du nerf radial. Int\u00e9r\u00eat dans la physiopathologie des \u00e9picondylalgies [The relation of the short radial extensor muscle of the wrist with the deep branch division of the radial nerve. Its significance in the physiopathology of elbow pain]","volume":"13","author":"Laulan","year":"1994","journal-title":"Ann Chir Main"},{"key":"R30-20250512","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.2106\/00004623-199811000-00006","article-title":"The column procedure: a limited lateral approach for extrinsic contracture of the elbow","volume":"80","author":"Mansat","year":"1998","journal-title":"J Bone Joint Surg Am"},{"key":"R33-20250512","first-page":"453","article-title":"Results of open arthrolysis for elbow stiffness. A series of 22 cases","volume":"77","author":"Ayadi","year":"2011","journal-title":"Acta Orthop Belg"},{"key":"R34-20250512","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.jse.2013.04.019","article-title":"Surgical treatment of elbow stiffness caused by post-traumatic heterotopic ossification","volume":"22","author":"Koh","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"key":"R35-20250512","first-page":"373","article-title":"Combination of arthrolysis by lateral and medial approaches and hinged external fixation in the treatment of stiff elbow","volume":"70","author":"Liu","year":"2011","journal-title":"J Trauma"},{"key":"R36-20250512","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1097\/01.ta.0000196000.96056.51","article-title":"Outcome of open release for post-traumatic elbow stiffness","volume":"61","author":"Tan","year":"2006","journal-title":"J Trauma"},{"key":"R37-20250512","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00402-012-1659-4","article-title":"Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows","volume":"133","author":"Ruan","year":"2013","journal-title":"Arch Orthop Trauma Surg"},{"key":"R38-20250512","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.2106\/JBJS.I.01367","article-title":"Surgical release for posttraumatic loss of elbow flexion","volume":"92","author":"Park","year":"2010","journal-title":"J Bone Joint Surg Am"},{"key":"R39-20250512","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.2106\/JBJS.K.00972","article-title":"Prevention of nerve injury during arthroscopy capsulectomy of the elbow utilizing a safetydriven strategy","volume":"95","author":"Bionna","year":"2013","journal-title":"J Bone Joint Surg Am"},{"key":"R40-20250512","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.jse.2013.01.032","article-title":"Arthroscopic elbow surgery, is it safe?","volume":"22","author":"Elfeddali","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"key":"R41-20250512","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.jse.2012.12.001","article-title":"The first 100 elbow arthroscopies of one surgeon: analysis of complications","volume":"22","author":"Marti","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"key":"R42-20250512","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jse.2013.09.026","article-title":"Elbow arthroscopy: early complications and associated risk factors","volume":"23","author":"Nelson","year":"2014","journal-title":"J Shoulder Elbow Surg"}],"container-title":["Techniques in Hand &amp; Upper Extremity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T16:08:40Z","timestamp":1747066120000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,28]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bth.0000000000000312","relation":{},"ISSN":["1531-6572"],"issn-type":[{"value":"1531-6572","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,28]]}}}