Medial Approach to Elbow Joint (see comments 
):
Its uses:
1.decompression and/or transposition of the ulnar nerve
2.Ulnar removal of loose bodies
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ORIF of the ulnar coronoid process and the medial humeral condyle and epicondyle.
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debridement and reattachment of common flexor wad for medial epicondylitis
Position of the Patient
Supine with arm flexed and supported by arm board over the patient.
Landmarks and Incision
Landmarks:
Medial epicondyle of the humerus.
Incision:
Make a Curved incision 8 to 10 cm long on the medial aspect of the elbow, Centered over the medial epicondyle.
Internervous plane
Proximally between:
Brachialis muscle: which innervate by the musculocutaneous nerve.
Triceps muscle: which innervate by the radial nerve.
Distally between:
Brachialis muscle: which innervate by the musculocutaneous nerve.
Pronator teres muscle: which innervate by the median nerve.
Superficial dissection
Incise the fascia over the ulnar nerve starting proximally
Iisolate nerve along the entire length of the incision
Expose the common flexor origin on the medial epicondyle
Develop brachialis and PT interval
Avoid the median nerve which enters PT near the midline
If necessary can perform osteotomy of the medial epicondyle
Osteotomy is reflected distally
Ensure retained MCL ligament into osteotomy fragment
Develop brachialis and triceps interval
Deep dissection
Incise capsule and medial collateral ligament
Dangerous:
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Ulnar nerveis at risk during approachmust be dissected out to ensure protection
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Median nerve aggressive traction on the osteotomy fragment can cause a traction injury to the median and anterior interosseous nerves.