Tips and Techniques in Elbow Surgery: A Practical Approach

Preface
Contents
Contributors
Part I: Elbow Trauma
	1: Open Reduction Internal Fixation (ORIF) for Radial Head and Neck Fractures
		1.1	 Introduction
		1.2	 Associated Injuries
		1.3	 Imaging
		1.4	 Initial Evaluation/Examination
		1.5	 Classification
		1.6	 Treatment Algorithm
		1.7	 Surgical Treatment
			1.7.1	 Implants and Equipment
			1.7.2	 Positioning
			1.7.3	 Surgical Approach
				1.7.3.1	 Kocher Approach
				1.7.3.2	 Kaplan Approach
			1.7.4	 Reduction and Fixation
			1.7.5	 Bailout
		1.8	 Take Away Points
		References
	2: Open Reduction and Internal Fixation (ORIF) for Distal Humerus Fractures
		2.1	 Background and Key Principles
		2.2	 Indications
		2.3	 Contraindications
		2.4	 Special Considerations
		2.5	 Anesthesia and Positioning
		2.6	 Tips, Pearls, and Lessons Learned
			2.6.1	 Olecranon Osteotomy
			2.6.2	 Order of Reduction
			2.6.3	 Intraoperative Mobility Assessment
		2.7	 Difficulties Encountered
		2.8	 Key Procedural Steps
			2.8.1	 Exposure and Approach
			2.8.2	 Fixation
		2.9	 Bailout, Rescue, and Salvage Procedures
		References
	3: Total Elbow Arthroplasty (TEA) for Distal Humerus Fractures
		3.1	 Introduction
		3.2	 Pre-Operative Assessment
		3.3	 Patient Positioning
		3.4	 Surgical Approaches
		3.5	 Key Technical Steps
			3.5.1	 Exposure of the Elbow
			3.5.2	 Implant Sizing
			3.5.3	 Humerus Preparation
			3.5.4	 Radial Head Preparation
			3.5.5	 Ulna Preparation
			3.5.6	 Trial and Implantation
			3.5.7	 Closure
		3.6	 Intra-Operative Challenges
			3.6.1	 Fracture Comminution and Poor Bone Stock
			3.6.2	 Intra-Operative Fracture
			3.6.3	 Instability
			3.6.4	 Impingement
			3.6.5	 Ulnar Component Pistoning
			3.6.6	 Post-Operative Ulnar Neuropathy
		3.7	 Post-Operative Protocol
		3.8	 Linked vs. Unlinked vs. Hemiarthroplasty
		3.9	 Outcomes
		3.10	 Pitfalls
		3.11	 Multiple Choice Questions
		References
	4: The Internal Elbow Joint Stabilizer
		4.1	 Key Principles
		4.2	 Indications
		4.3	 Expectations
		4.4	 Contraindications
		4.5	 Special Instructions, Positioning, and Anesthesia
		4.6	 Tips, Pearls, and Lessons Learned
		4.7	 Key Procedural Steps
		4.8	 Pitfalls
		4.9	 Bailout, Rescue, and Salvage Procedures
		References
	5: Open Reduction Internal Fixation (ORIF) for Olecranon Fractures
		5.1	 Description
		5.2	 Key Principles
		5.3	 Expectations
		5.4	 Indications
		5.5	 Contraindications
		5.6	 Special Consideration
		5.7	 Special Instructions, Positioning, and Anaesthesia
		5.8	 Tips, Pearls, and Lessons Learned
			5.8.1	 Bare Area
			5.8.2	 Varus Angle
			5.8.3	 Ulnar Nerve
			5.8.4	 Perfusion
			5.8.5	 Intermediate Fragments
			5.8.6	 Triceps Off-Loading Suture
		5.9	 Difficulties Encountered
		5.10	 Key Procedural Steps
		5.11	 Bailout, Rescue, and Salvage Procedures
		References
	6: Treatment Options for Nonunion of the Olecranon
		6.1	 Introduction
		6.2	 Angiosome-Informed Incision Design
		6.3	 How Fixation Fails: Pitfalls of Conventional Olecranon Fixation Strategies
			6.3.1	 Tension Band Wiring
			6.3.2	 Plate and Screw Fixation
			6.3.3	 Intramedullary Fixation
		6.4	 Novel Implants and Their Relevance to the Failed Olecranon Fracture
		6.5	 Modes of Failure and How to Address Them
			6.5.1	 Necessity of a Strict Post-Operative Protocol
			6.5.2	 Loss of Hardware Fixation
			6.5.3	 Delayed Union, Infection, and Bone Loss
		6.6	 Conclusion
		6.7	 Questions
		References
	7: Radial Head Replacement
		7.1	 Description
		7.2	 Key Principles
		7.3	 Expectations
		7.4	 Indications
		7.5	 Contraindications
		7.6	 Special Considerations
		7.7	 Special Instructions, Positioning, and Anesthesia
		7.8	 Tips, Pearls, and Lessons Learned
			7.8.1	 Choice of Approach
			7.8.2	 Radial Neck Resection and Radial Shaft Preparation
			7.8.3	 Sizing
			7.8.4	 Assessing the Trial Implant
			7.8.5	 Treatment of Associated Injuries
		7.9	 Difficulties Encountered
		References
	8: Open Reduction Internal Fixation (ORIF) for Capitellum Fractures
		8.1	 Epidemiology and Surgical Anatomy
		8.2	 Classification
		8.3	 Tips, Pearls, and Lessons Learned
		8.4	 Arthroscopic Treatment
		8.5	 Complications
		8.6	 Tips, Tricks and Pitfalls
		References
	9: Open Reduction Internal Fixation (ORIF) for Trochlear Fractures
		9.1	 Introduction
		9.2	 Preoperative Planning
			9.2.1	 Images
			9.2.2	 Classifications
				9.2.2.1	 Bryan and Morrey
				9.2.2.2	 Dubberley
				9.2.2.3	 Ring
		9.3	 Surgical Technique
			9.3.1	 Patient Position
			9.3.2	 Approach
				9.3.2.1	 Olecranon Osteotomy
				9.3.2.2	 Lateral Extensile
				9.3.2.3	 Medial Based Approaches
			9.3.3	 Fracture Fixation
			9.3.4	 Closing
		9.4	 Arthroscopic-Assisted Reduction and Internal Fixation (AARIF)
		9.5	 Postoperative Management
		9.6	 Results
		9.7	 Complications
		9.8	 Questions
		References
	10: Open Reduction Internal Fixation (ORIF) for Coronoid Fractures
		10.1	 Injury Patterns and Fracture Classification
		10.2	 Surgical Indications
		10.3	 Preoperative Considerations
		10.4	 Positioning and Anesthesia
		10.5	 Exposures
			10.5.1	 Coronoid Tip Fracture
			10.5.2	 Anteromedial Coronoid Fracture
			10.5.3	 Basal Coronoid Fracture
		10.6	 Fixation Methods
			10.6.1	 Coronoid Tip Fracture
			10.6.2	 Anteromedial Coronoid Fracture
			10.6.3	 Basal Coronoid Fracture
		10.7	 Structures at Risk
		10.8	 Key Procedure Steps
			10.8.1	 Coronoid Tip Fracture ORIF in Terrible Triad Injuries
			10.8.2	 Anteromedial Coronoid Fracture ORIF
			10.8.3	 Basal Coronoid Fracture ORIF in Transolecranon Fracture-Dislocations
			10.8.4	 Coronoid Fracture ORIF in Monteggia Fracture-Dislocations
		10.9	 Knowledge Testing Questions
		References
	11: External Fixation of the Elbow
		11.1	 Introduction
		11.2	 Biomechanics
		11.3	 Indications
		11.4	 Surgical Technique/Tips
		11.5	 Complications
		References
	12: Surgical Treatment of Pediatric Supracondylar Humerus Fractures
		12.1	 Description
		12.2	 Key Principles
			12.2.1	 Evaluation
			12.2.2	 Reduction
			12.2.3	 Fixation
		12.3	 Expectations
		12.4	 Indications
		12.5	 Contraindications
		12.6	 Special Considerations
			12.6.1	 Neurovascular Compromise
			12.6.2	 Medial Comminution
			12.6.3	 Flexion-Type
			12.6.4	 Occult T-Type
		12.7	 Special Instructions, Positioning, Anesthesia
		12.8	 Tips, Pearls, and Lessons Learned
			12.8.1	 Pin Sizing
			12.8.2	 Traction and Milking
			12.8.3	 Pronation/Supination
		12.9	 Difficulties Encountered
			12.9.1	 Global Instability
			12.9.2	 Open Reduction in Flexion vs. Extension Types
			12.9.3	 Entrapment of Neurovascular Structures
			12.9.4	 Compartment Syndrome
		12.10	 Key Procedural Steps
		12.11	 Open Reduction or Exploration
		References
Part II: Degenerative Conditions of the Elbow
	13: Revision Total Elbow Arthroplasty (TEA) with Osseous Augmentation
		13.1	 Key Principles
		13.2	 Indications
		13.3	 Contraindications
		13.4	 Special Considerations
		13.5	 Special Instructions, Positioning, and Anesthesia
		13.6	 Tips, Pearls, and Lessons Learned
			13.6.1 Exposure
		13.7	 Humeral Bone Loss
		13.8	 Ulnar Bone Loss
		13.9	 Difficulties Encountered
			13.9.1 Considerations
		13.10	 Key Procedural Steps
		13.11	 Techniques
			13.11.1 Implant Removal
			13.11.2 Impaction Grafting Technique
			13.11.3 Allograft Prosthetic Composite (APC)
			13.11.4 Ulnar Bone Loss
		13.12	 Pearls and Pitfalls
		13.13	 Bailout, Rescue, and Salvage Procedures
			13.13.1 Infection
		13.14	 Postoperative Care
		13.15	 Outcomes
		13.16	 Complications
		References
	14: Interposition Arthroplasty of the Elbow
		14.1	 Introduction
		14.2	 Indications/Selection
		14.3	 Contraindications
		14.4	 History
		14.5	 Physical Examination
		14.6	 Imaging
		14.7	 Decision/Discussion
		14.8	 Preoperative Planning
		14.9	 Procedure [5]
		14.10	 Post Procedure
		14.11	 Examination Under Anesthesia
		14.12	 Further Rehabilitation
		14.13	 Results and Expectations
		References
	15: Open Treatment of the Stiff Elbow
		15.1	 Description
		15.2	 Key Principles
		15.3	 Expectations
		15.4	 Indications
		15.5	 Contra-Indications
		15.6	 Special Considerations
		15.7	 Lateral Column Procedure: Procedural Steps
			15.7.1 Positioning and Exposure
			15.7.2 Exposing the Anterior Capsule
			15.7.3 Exposing the Posterior Capsule
			15.7.4 Postoperative Management
		15.8	 Medial Column Procedure: Procedural Steps
			15.8.1 Approach
			15.8.2 Exposing the Ulnar Nerve and the Medial Fascia
			15.8.3 Exposing the Anterior Capsule for Excision and Incision
			15.8.4 Exposing and Excising the Posterior Capsule and Bone Spurs
			15.8.5 Ulnar Nerve Transposition
			15.8.6 Closure
		15.9	 Handling Difficulties
		15.10	 Bailout and Salvage
			15.10.1 Combined Lateral and Medial Approaches
			15.10.2 Distraction Arthroplasty
			15.10.3 Interpositional Arthroplasty
		Suggested Readings
	16: Total Elbow Replacement
		16.1	 Description
		16.2	 Key Principles
		16.3	 Expectations
		16.4	 Indications
		16.5	 Contraindications
		16.6	 Special Considerations
		16.7	 Special Instructions, Positioning, and Anesthesia
		16.8	 Tips, Pearls, and Lessons Learned
		16.9	 Difficulties Encountered
		16.10	 Key Procedural Steps
		16.11	 Bailout, Rescue, and Salvage Procedures
		References
	17: Revision Total Elbow Replacement
		17.1	 Background of Revision Elbow Arthroplasty
		17.2	 Modes of Failure of a Total Elbow Replacement
			17.2.1	 Aseptic Loosening
			17.2.2	 Infection
			17.2.3	 Wear
			17.2.4	 Periprosthetic Fracture
		17.3	 Assessment
			17.3.1	 Diagnosing Infection
			17.3.2	 Assessment of Loosening, Fracture, and Bone Stock
				17.3.2.1	 Additional Considerations
		17.4	 Surgical Options
			17.4.1	 Debridement, Antibiotics, and Implant Retention (DAIR)
			17.4.2	 Single Stage Revision
			17.4.3	 Two-Stage Revision
		17.5	 Technical Considerations
			17.5.1	 Implant Removal
			17.5.2	 Management of Bone Loss
				17.5.2.1	 Autograft
				17.5.2.2	 Allografts
				17.5.2.3	 Allograft Prosthesis Composite (APC)
				17.5.2.4	 Megaprosthesis
		17.6	 Unit Experience
		References
	18: Radiocapitellar Replacement
		18.1	 Description
		18.2	 Key Principles
		18.3	 Expectations
		18.4	 Indications
		18.5	 Contraindications
		18.6	 Special Considerations
			18.6.1	 Clinical Examination
			18.6.2	 Radiographic Examination
		18.7	 Special Instructions, Positioning, and Anesthesia
		18.8	 Tips, Pearls, and Lessons Learned
		18.9	 Difficulties Encountered
		18.10	 Key Procedural Steps
		18.11	 Bailout, Rescue, and Salvage Procedures
		References
	19: Hemiarthroplasty of the Elbow
		19.1	 Description and Key Principles
			19.1.1	 Key Principles
			19.1.2	 Expectations
			19.1.3	 Indications
			19.1.4	 Contraindications
		19.2	 Special Considerations
		19.3	 Positioning and Anaesthesia
		19.4	 Tips, Pearls, and Lessons Learned
			19.4.1	 Condylar Fixation
			19.4.2	 Prosthetic Placement
		19.5	 Key Procedural Steps
		19.6	 Postoperative Management
		19.7	 Difficulties Encountered
		19.8	 Bailout, Rescue, and Salvage Procedures
		Further Reading
	20: Arthroscopic Management of the Stiff Elbow
		20.1	 Description
		20.2	 Key Principle
		20.3	 Expectation
		20.4	 Indication
		20.5	 Contraindication
		20.6	 Special Consideration
			20.6.1	 Preoperative nerve imaging in HO
			20.6.2	 Simple Vs. Complex Contracture
			20.6.3	 Optimal Timing to Remove HO
			20.6.4	 Loss of Supination-Pronation in HO [17]
		20.7	 Special Instructions, Positioning, and Anesthesia
			20.7.1	 Patient Positioning Is Important
			20.7.2	 Safely Creating the Anterolateral Portal
		20.8	 Tips, Pearls, and Lessons Learned
			20.8.1	 Stay Below Your Curve: Always Keep a Margin of Safety
			20.8.2	 Know Where the Nerves Are
			20.8.3	 Use Retractors
			20.8.4	 Avoid Swelling
			20.8.5	 Detach Suction Tubing from Shaver
			20.8.6	 Do not Use a Burr Near the Ulnar Nerve
			20.8.7	 Shorten Your Grip on the Burr for Better Control
			20.8.8	 Use a Consistent Step-Wise Strategy
			20.8.9	 Have an Experienced Assistant
			20.8.10 Anticipate and Limit Adversity
		20.9	 Difficulties Encountered
			20.9.1	 Proximal Anteromedial Portal (PAMP) with Prior Ulnar Nerve Transposition
		20.10	 Key Procedure Steps
			20.10.1 Posterior Compartment
				20.10.1.1	 Step 1: Get in and Establish a View
				20.10.1.2	 Step 2: Create a Space in Which to Work
				20.10.1.3	 Step 3: Bone removal
				20.10.1.4	 Step 4: Capsulectomy
			20.10.2 Medial Gutter
			20.10.3 Lateral Gutter
			20.10.4 Anterior Compartment
				20.10.4.1	 Step 1: Get in and Establish a View
				20.10.4.2	 Step 2: Create a Space in Which to Work
				20.10.4.3	 Step 3: Bone Removal
				20.10.4.4	 Step 4: Capsulectomy
			20.10.5 Closure
			20.10.6 Postoperative Regimen
		20.11	 Bailout, Rescue, and Salvage
			20.11.1 Delayed Onset Ulnar Neuritis (DOUN)
		References
Part III: Elbow Arthroscopy
	21: Positioning and Portal Placement in Elbow Arthroscopy
		21.1	 History and Complications
		21.2	 Indications [2]
		21.3	 Contraindications [5]
		21.4	 Anesthesia
		21.5	 Patient positioning
			21.5.1	 Lateral Decubitus (Authors’ Preference)
			21.5.2	 Supine Position
			21.5.3	 Prone Position
		21.6	 Instruments
		21.7	 Portals [4, 6]
			21.7.1	 Anterior Elbow Arthroscopy
			21.7.2	 Posterior Elbow Arthroscopy
		References
	22: Basic Procedures in Elbow Arthroscopy
		22.1	 Tips and Tricks
		22.2	 Arthroscopic Synovectomy
		22.3	 Arthroscopic Treatment of the Tennis Elbow
		22.4	 Arthroscopic Treatment
		22.5	 Arthroscopic Removal of Loose Bodies
		22.6	 Removal
		22.7	 Arthroscopic Removal of Synovial Plica
		References
	23: Arthroscopic Management of Elbow Instability
		23.1	 Description
		23.2	 Key Principles
		23.3	 Expectations
		23.4	 Indications
		23.5	 Contra-Indications
		23.6	 Special Considerations
		23.7	 Special Instructions, Positioning, and Anesthesia
		23.8	 Tips, Pearls, and Lessons Learned
			23.8.1	 Hemarthrosis
			23.8.2	 Anterior Compartment
			23.8.3	 Posterior Compartment
		23.9	 Difficulties Encountered
		23.10	 Key Procedural Steps
		23.11	 Bailout, Rescue, and Salvage Procedures
		References
	24: Endoscopic Cubital Tunnel Release
		24.1	 Introduction
		24.2	 Indications
		24.3	 Surgical Technique
		24.4	 Outcomes
		References
Part IV: Sports Conditions of the Elbow
	25: Reconstruction of the Elbow Lateral Ulnar Collateral Ligament (LUCL)
		25.1	 Indications for Reconstruction of the Elbow LUCL
		25.2	 Graft Selection
		25.3	 Surgical Technique
			25.3.1	 Patient Positioning
			25.3.2	 Surgical Exposure
			25.3.3	 Bone Preparation
			25.3.4	 Graft Preparation
			25.3.5	 Graft Passage and Fixation
		25.4	 Postoperative Rehabilitation
		25.5	 Pearls
		25.6	 Pitfalls
		25.7	 Future Directions
	26: Dual Incision Distal Biceps Repair
		26.1	 Description
		26.2	 Key Principles
		26.3	 Expectations
		26.4	 Indications
		26.5	 Contraindications
		26.6	 Special Considerations
		26.7	 Special Instructions, Positioning, and Anesthesia
		26.8	 Critical Pearls for Success
		26.9	 Difficulties Encountered
		26.10	 Approach for Two-Incision Repair Techniques
		26.11	 Traditional Mini-Two-Incision Repair
		26.12	 Two-Incision Cortical Button Onlay Technique
		26.13	 Complications
		References
	27: Single Incision Distal Biceps Repair
		27.1	 Description
		27.2	 Key Principles
		27.3	 Expectations
		27.4	 Indications
		27.5	 Contraindications
		27.6	 Special Considerations
		27.7	 Special Instructions, Positioning, and Anesthesia
		27.8	 Tips, Pearls, and Lessons Learned
		27.9	 Difficulties Encountered
		27.10	 Key Procedural Steps
		27.11	 Bailout, Rescue, and Salvage Procedures
		27.12	 Pitfalls
		References
	28: Arthroscopic Osteochondral Grafting for Capitellar Osteochondritis Dissecans (OCD)
		28.1	 Description
		28.2	 Principles
		28.3	 Indications
		28.4	 Contraindications
		28.5	 Procedural Steps
			28.5.1	 Positioning and Preparation
			28.5.2	 Diagnostic Arthroscopy
			28.5.3	 Osteochondral Grafting: Measuring Defect Size and Creating Recipient Socket
			28.5.4	 Osteochondral Grafting: Harvesting the Osteochondral Graft from the Knee
			28.5.5	 Osteochondral Grafting: Inserting the Harvested Osteochondral Graft into the Capitellum
		28.6	 Handling Difficulties
		28.7	 Bailout and Salvage
		References
	29: ORIF Treatment of Olecranon Stress Fracture for Sports Players
		29.1	 Description
		29.2	 Key Principles
		29.3	 Expectation
		29.4	 Indication
		29.5	 Contraindication
		29.6	 Special Consideration
		29.7	 Indications for Surgery
		29.8	 Special Instructions, Positioning, and Anesthesia
		29.9	 Tips, Pearls, and Lessons Learned
		29.10	 Difficulties Encountered
			29.10.1	 An OSF Patient with Incomplete Union
			29.10.2	 A Patient with Complications of OSF and UCL Injuries
		29.11	 Key Procedure Steps
		29.12	 Bailout, Rescue, and Salvage
		29.13	 Pitfalls
		References
	30: Revision UCL Reconstruction: Humeral Side
		30.1	 Expectations
		30.2	 Indications
		30.3	 Contraindications
		30.4	 Special Considerations
		30.5	 Special Instructions, Positioning, and Anesthesia
		30.6	 Tips, Pearls, and Lessons Learned
		30.7	 Difficulties Encountered
		30.8	 Key Procedural Steps
		30.9	 Bailout, Rescue, and Salvage Procedures
		30.10	 Pitfalls
		References
	31: Revision UCL Reconstruction: Ulnar Side
		31.1	 Introduction
		31.2	 Indications
		31.3	 Contraindications
		31.4	 Author Preferred Technique/Procedure
			31.4.1	 Preoperative Planning
				31.4.1.1	 Patient Positioning
			31.4.2	 Approach
			31.4.3	 Graft Selection
			31.4.4	 Step-by-Step Description of the Technique
			31.4.5	 Techniques to Address Ulnar Bone Loss, Insufficiency, or Fracture
			31.4.6	 Complications and Management
			31.4.7	 Postoperative Care
			31.4.8	 Outcome
		31.5	 Summary
		References
	32: Failed Tennis Elbow Surgery Syndrome (FTESS)
		32.1	 Introduction
			32.1.1	 Failed Tennis elbow Surgery Syndrome (FTESS)
		32.2	 Clinical Evaluation
		32.3	 Etiology
		32.4	 Diagnostics
			32.4.1	 Type I: Wrong Patient and Diagnosis
				32.4.1.1	 Type Ia: Wrong Patient
				32.4.1.2	 Type Ib: Wrong Diagnosis
			32.4.2	 Type II: Wrong Surgery
				32.4.2.1	 Type IIa: Inadequate Removal of Pathology
				32.4.2.2	 Type IIb: Iatrogenic Cause
			32.4.3	 Type III: Wrong Time
		32.5	 Treatment
		32.6	 Conclusions
		References
	33: Distal Biceps Tendon Endoscopy
		33.1	 Basic Science
			33.1.1	 Anatomy
			33.1.2	 Pathology
		33.2	 Clinical
			33.2.1	 Presentation
			33.2.2	 Examination
			33.2.3	 Imaging
				33.2.3.1	 X-Rays
				33.2.3.2	 Ultrasound
				33.2.3.3	 MRI
				33.2.3.4	 4D-CT
		33.3	 Treatment Principles
			33.3.1	 Single Portal ‘Dry’ Endoscopy
			33.3.2	 Tendinopathy and Partial Tears
			33.3.3	 Complete Tears (Fig. 33.11)
			33.3.4	 All-Endoscopic Technique
			33.3.5	 Dual Suture Anchor Technique
			33.3.6	 Endobutton Technique
			33.3.7	 BicepsButton and Interference Screw Technique
			33.3.8	 Tips and Tricks
			33.3.9	 Pitfalls
		References
	34: Distal Biceps Reconstruction with Allograft for Chronic Tears
		34.1	 Description
		34.2	 Key Principles
		34.3	 Expectations
		34.4	 Indications
		34.5	 Contra-Indications
		34.6	 Special Considerations
		34.7	 Graft Type
		34.8	 Surgical Technique
			34.8.1	 Approach
			34.8.2	 Graft Fixation
			34.8.3	 Special Instructions, Positioning, and Anesthesia
			34.8.4	 Key Procedure Steps
				34.8.4.1	 Single Anterior Incision Technique
				34.8.4.2	 Two-Incision Technique
			34.8.5	 Tips, Pearls, and Lessons Learned
			34.8.6	 Pitfalls
		34.9	 Rehabilitation
		34.10	 Outcomes and Complications
		References
	35: Open Tennis Elbow Surgery
		35.1	 Description
		35.2	 Clinical Presentation
		35.3	 Key Principles
		35.4	 Anconeus Flap
			35.4.1	 Outcome
			35.4.2	 Indications
			35.4.3	 Relative Contraindications
			35.4.4	 Special Considerations
			35.4.5	 Pitfalls
			35.4.6	 Key Procedural Steps
			35.4.7	 Bail-Out and Rescue Procedures
		References
	36: Medial Ulnar Collateral Ligament (MUCL) Repair with Internal Brace Augmentation
		36.1	 Introduction
		36.2	 Surgical Technique
		36.3	 Rehabilitation
		36.4	 Outcomes
		36.5	 Conclusions
		References
	37: Medial Ulnar Collateral Ligament (MUCL) Reconstruction Using the Docking Technique
		37.1	 Description
		37.2	 Key Principles
		37.3	 Expectations
		37.4	 Indications
		37.5	 Contraindications
		37.6	 Special Considerations
		37.7	 Special Instructions, Positioning, and Anesthesia
		37.8	 Equipment Needed
		37.9	 Tips, Pearls, and Lessons Learned
		37.10	 Difficulties Encountered
		37.11	 Key Procedural Steps 1, 2
		37.12	 Bailout, Rescue, and Salvage Procedures
		37.13	 Pitfalls
		References
	38: Medial Ulnar Collateral Ligament (MUCL) Reconstruction Using the Anatomic Technique
		38.1	 Pre-operative Planning and Positioning
		38.2	 Graft Harvest
		38.3	 Incision and Exposure
		38.4	 Preparation of Humeral Socket on Medial Epicondyle
		38.5	 Preparation of Proximal Ulnar Footprint
		38.6	 Preparation of Distal Ulnar Footprint and Graft Fixation
		38.7	 Internal Brace Augmentation
		38.8	 Postoperative Management
		38.9	 Conclusion
		References
	39: Osteochondral Autograft Transplantation Surgery (OATS) for Capitellar Osteochondritis Dissecans (OCD)
		39.1	 OCD: Etiology and Epidemiology
		39.2	 Treatment
			39.2.1	 Surgical Management
		39.3	 Open OATS: Surgical Walkthrough
			39.3.1	 Recipient Site Exposure
			39.3.2	 Recipient Site Preparation
			39.3.3	 Donor Site Autograft Harvest
			39.3.4	 Graft Acceptance
			39.3.5	 Complications
		39.4	 Rehabilitation and Return to Sport
		39.5	 Summary
		References
	40: Triceps Tendon Repair
		40.1	 Description
		40.2	 Key Principles
		40.3	 Expectations
		40.4	 Indications
		40.5	 Contraindications
		40.6	 Special Considerations
		40.7	 Special Instructions, Positioning, and Anesthesia
		40.8	 Tips, Pearls, and Lessons Learned
		40.9	 Difficulties Encountered
		40.10	 Key Procedural Steps for Preferred Technique (Double Row Suture Anchor)
		40.11	 Bailout, Rescue, and Salvage Procedures
		References
	41: Endoscopic Distal Triceps Repair
		41.1	 Description
		41.2	 Key Principles
		41.3	 Introduction/Expectations
		41.4	 Indications
		41.5	 Contraindications
		41.6	 Preoperative Considerations
			41.6.1	 Physical Exam
			41.6.2	 Imaging
				41.6.2.1	 X-Rays
				41.6.2.2	 Ultrasound
				41.6.2.3	 Magnetic Resonance Imaging (MRI)
		41.7	 Procedure Technique
			41.7.1	 Equipment
			41.7.2	 Positioning
			41.7.3	 Surgical Procedure
			41.7.4	 Post-procedure Protocol
		41.8	 Author’s Tips/Tricks/Pearls
			41.8.1	 Tip 1
			41.8.2	 Tip 2
			41.8.3	 Tip 3
			41.8.4	 Tip 4
			41.8.5	 Tip 5
			41.8.6	 Tip 6
		41.9	 Potential Complications
		References
	42: Open Excision of Posteromedial Olecranon Osteophyte in Throwing Athletes
		42.1	 Description
		42.2	 Key Principles
		42.3	 Expectations
		42.4	 Indications
		42.5	 Contraindications
		42.6	 Special Considerations
		42.7	 Special Instructions, Positioning, and Anesthesia
		42.8	 Tips, Pearls, and Lessons Learned
			42.8.1	 Exposure
			42.8.2	 Equipment and Tools
		42.9	 Difficulties Encountered
		42.10	 Key Procedural Steps
		42.11	 Bailout, Rescue, and Salvage Procedures
		References
			Suggested Reading
	43: Flexor Pronator Repair
		43.1	 Description
		43.2	 Key Principles
		43.3	 Expectations
		43.4	 Indications
		43.5	 Contraindications
		43.6	 Special Considerations
		43.7	 Special Instructions, Positioning, and Anesthesia
		43.8	 Tips, Pearls, and Lessons Learned
		43.9	 Difficulties Encountered
		43.10	 Key Procedural Steps
		43.11	 Bailout, Rescue, Salvage Procedures
		43.12	 Pitfalls
		References
	44: Arthroscopic Management of Valgus Extension Overload
		44.1	 Introduction
		44.2	 Background
		44.3	 Clinical Evaluation
		44.4	 Diagnostics
		44.5	 Treatment
		44.6	 Results
		44.7	 Conclusion
		References
Part V: Neurologic Conditions of the Elbow
	45: Radial Nerve Decompression
		45.1	 Goals and Expectations
		45.2	 Radial Tunnel Anatomy
		45.3	 Indications
		45.4	 Contraindications
		45.5	 Pre-Operative Preparation and Positioning
			45.5.1	 Anterior Approach
			45.5.2	 Posterior Approach
		45.6	 Tips and Pearls (Posterior Approach)
		45.7	 What to Avoid
		45.8	 Complications/Bailout/Salvage
		45.9	 Post-operative Care
		Further Reading
	46: Ulnar Nerve Decompression
		46.1	 Description
		46.2	 Key Principles
		46.3	 Expectations
		46.4	 Indications
		46.5	 Contraindications
		46.6	 Special Considerations
		46.7	 Special Instructions, Positioning, and Anesthesia
		46.8	 Tips, Pearls, and Lessons Learned
		46.9	 Difficulties Encountered
		46.10	 Key Procedural Steps
		46.11	 Bailout, Rescue, and Salvage Procedures
	47: Anterior Subcutaneous Ulnar Nerve Transposition
		47.1	 Background
		47.2	 Expectations
		47.3	 Indications
		47.4	 Contraindications
		47.5	 Special Considerations
		47.6	 Special Instructions, Positioning, and Anesthesia
		47.7	 Tips, Pearls, and Lessons Learned
			47.7.1	 Anconeus Epitrochlearis
			47.7.2	 Ulnar Collateral Ligament Injury
		47.8	 Difficulties Encountered
		47.9	 Key Procedural Steps
		47.10	 Bailout, Rescue, and Salvage Procedures
		47.11	 Pitfalls
		References
Index