An Anatomical Study on Canine Cadavers Investigating the Caudolateral Approach - Elevation of the Anconeus Muscle and Splitting of the Triceps Brachii Muscle for the Potential Treatment of T-Y Humeral Fractures

Sep 30, 2026

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Complex anatomy of the distal humerus, elbow joint, and surrounding soft tissues (triceps brachii muscle, large nerves, and vessels) makes distal humerus and humeral condyle fractures difficult to manage. Strong internal fixation is often required. The study proposes a caudolateral approach using elevation of the anconeus muscle and splitting the triceps brachii to improve exposure. Results from 16 canine cadavers quantify articular cartilage visibility before and after olecranon osteotomy, supporting this approach as a useful alternative, while indicating need for clinical validation.

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CategoryHealthcare

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Article An Anatomical Study on Canine Cadavers Investigating the Caudolateral Approach Involving the Elevation of the Anconeus Muscle and Splitting of the Triceps Brachii Muscle for the Potential Treatment of T-Y Humeral Fractures Piotr Tr˛ebacz 1, *, Jan Frymus 1, *, Michał Czopowicz 2, Anna Barteczko 3, Mateusz Pawlik 4 and Aleksandra Kurkowska 4 Academic Editor: Roberto Tamburro Received: 31 October 2025 Revised: 17 December 2025 Accepted: 29 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Surgery and Anesthesiology of Small Animals, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland 2 Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland; [michal_czopowicz@sggw.edu.pl](michal_czopowicz@sggw.edu.pl) 3 CABIOMEDE Ltd., K. Olszewskiego 6, 25-663 Kielce, Poland; [anna.barteczko@cabiomede.com](anna.barteczko@cabiomede.com) 4 Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland; [mateusz.pawlik@cabiomede.com](mateusz.pawlik@cabiomede.com) (M.P.); [aleksandra.kurkowska@cabiomede.com](aleksandra.kurkowska@cabiomede.com) (A.K.) * [Correspondence: piotr_trebacz@sggw.edu.pl](Correspondence: piotr_trebacz@sggw.edu.pl) (P.T.); [jan_frymus@sggw.edu.pl](jan_frymus@sggw.edu.pl) (J.F.) Simple Summary Humeral condylar and epicondylar fractures (T-Y fractures), are one of the most challenging orthopedic injuries to treat in dogs. Despite advances in internal fixation techniques, complications following repairs to these fractures often occur. It is widely recognized that achieving anatomical reduction in intra-articular fractures is important for restoring joint function. Due to the anatomical complexity of the distal humerus and elbow joint, it is often difficult to expose all lines of a T-Y fracture appropriately. Currently, the combined lateral and medial approach is the preferred method for treating distal humeral fractures in small animals. This approach provides good exposure of the lateral and medial epicondyles and the humeral diaphysis. However, access to the articular surface of the condyle is limited. In this anatomical cadaveric study, we present the results of using the caudolateral approach, which involves elevating the anconeus muscle and splitting the triceps brachii. We find this approach useful because it provides good access to the condyle, the epicondyles, and the humeral shaft. It can also help surgeons see fracture lines more clearly during repair. Appropriate reduction and instrumentation of T-Y fractures are crucial for restoring elbow joint function. Abstract Due to the complex anatomical structure of the distal humerus, elbow joint, and the soft tissue mantle (the triceps brachii muscle, large nerves, and vessels), fractures of the distal humerus and humeral condyle are difficult to treat. In most cases, strong instrumentation is needed to stabilize the fractures. To improve exposure of the distal humerus and humeral condyle, we proposed a caudolateral approach that involves elevating the anconeus muscle and splitting the triceps brachii. This study presents the results of using this approach in 16 canine cadavers. After exposing the distal humerus and maximally flexing the elbow joint, photographs were taken of the condyle from the same distance before and after olecranon osteotomy. The visible surface area of the articular cartilage was then calculated in square pixels after calibrating the photographs. It was possible to reach the distal and middle humerus in all cases. The only vital structure t

FAQs

Why are T-Y humeral condylar and epicondylar fractures difficult to treat in dogs?

They involve intricate distal humerus and elbow anatomy surrounded by major soft tissues, including the triceps brachii, large nerves, and vessels, making adequate surgical exposure challenging. Strong instrumentation is often needed to stabilize repaired fractures.

What anatomical changes define the proposed caudolateral approach?

The approach involves elevating the anconeus muscle and splitting the triceps brachii to improve access to the distal humerus, humeral shaft, epicondyles, and the articular condylar surface.

What did the study measure, and how did olecranon osteotomy affect results?

Visible articular cartilage surface area on photographs was calculated after calibration before and after olecranon osteotomy. The visible area increased after osteotomy, with A0 (before) significantly smaller than A1 (after) in all dogs.

Sep 30, 2026

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