Lateral approach (Morrey). A, Skin incision for extensile Kocher approach. B, Deep fascia is incised along lateral margin of triceps proximally and along interval between anconeus and extensor carpi ulnaris distally. C, To preserve periosteal continuity, triceps tendon is reflected subperiosteally from tip of olecranon. D, Extensor mechanism of elbow is reflected medially, tip of olecranon is removed (inset), and common origin of extensors of forearm is released from lateral epicondyle and adjacent structures. Extensor muscles are elevated to expose anterior part of capsule of elbow in interval between brachialis and capsule. E, Lateral collateral ligament is identified and released as distally based flap that can be reattached later to anatomic site of its proximal attachment on humerus. With lateral collateral ligament carefully retracted, anterior part of capsule now can be exposed and resected way across to medial site. (Redrawn from Morrey BF: Post-traumatic contracture of the elbow: operative treatment, including distraction arthroplasty, J Bone Joint Surg 72[4]:601–618, 1990.) SEE TECHNIQUE 46.13.