The Kaplan approach is a frequently used lateral approach which provides excellent exposure of the:
Anterior facet of the coronoid process
Anterior facet of the distal humerus
2. Skin incision
The incision starts over the lateral supracondylar ridge, 5 cm proximal to the elbow joint. It passes distally to the lateral surface of the proximal forearm, posterior to the radial head.
Note Be careful of the radial nerve, which runs close to the radial head and neck. It divides into its superficial and deep branches at the level of the radial head.
3. Deep dissection
The deep fascia is incised in line with the skin incision.
4. Identification of the muscle intervals
The interval between the extensor muscle of the fingers and the long extensor muscle of the wrist is identified.
Starting from the anterior aspect of the lateral humeral epicondyle the dissection follows distally the interval between the extensor muscle of the fingers and the long extensor muscle of the wrist. This way the anterolateral aspect of the radiohumeral joint capsule is exposed.
5. Opening the joint
Incise the anterolateral joint capsule longitudinally.
6. Further exposure
Subperiosteal reflection of the brachioradialis and extensor carpi radialis longus anteriorly, and the triceps posteriorly will improve joint exposure.
Blunt retractors are recommended.
Note Be careful when placing the anterior retractor as the radial nerve is at risk.