Cloward hand-held blade retractors have long been valued by spine surgeons for retracting the carotid sheath and esophagus during cervical fusions. Lately, these short six-inch retractors have been elbowing their way into sports medicine sets by aiding anterior capsular release for flexion contracture. The right angle blades on typical knee retractors are too acute to be effective when the patient is in the supine position. By contrast, the broad concave blade of a Cloward retractor falls off at a 45° angle from their flat, easy-to-hold, ribbed handle.

Following a Kocher skin incision upon an elbow flexed to 90°, the fibers of the extensor carpiradialis longus (ECRL) are lifted. At this point, the retractor blade can be placed beneath both the brachialis muscle and the common extensor tendon. Elevation is performed anteriorly and medially, exposing the anterior capsule and leaving intact the lateral ulnar collateral ligament. Cloward blade retractors are offered in 13 mm, 18 mm, 20 mm and 24 mm widths. The three widest blades include a gently rolled lip at their distal most ends.

For a more rigorous discussion of retractors and retraction techniques in anterior capsular release, the reader may wish to refer to The Elbow, Master Techniques in Orthopaedic Surgery, edited by B. F. Morrey, Raven Press, Ltd., New York, 1994 (available through Lippincott Williams & Wilkins).

Humerus Areas, Vol. 2, No. 1