Shoulder anterior approach: Delto-Pectoral



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Surface markings:

Dangers:

  • Radial nerve (and the superficial branch)

  • Lateral cutaneous nerve of forearm (5cm from elbow crease)

Waymarkers:

  • Retract Biceps medially and retract lateral antebrachial cutaneous nerve with it.

  • Between Brachialis (Radial & musculocutaneous nerve) and Brachioradialis (radial nerve)

  • Develop intermuscular plane between these 2 muscles

  • Brachialis also goes medially with the biceps muscle and tendon

Posterior Approach to the humerus: for inferior 2/3rds of humerus

Stanley 1999 JBJS approach with both splitting and reflection of the triceps



Surface markings:

Dangers:


Waymarkers:


Lateral Approach to the humerus: for Holsteine Lewis fracture of distal 1/3 of humus with radial nerve palsy ideal for exploring

Muscle splitting plane

Surface markings:

  • Lateral supracondylar ridge between brachioradialis in upper 1/3 and ECRL in lower 1/3

Dangers:

  • Radial nerve pierces lateral septum between proximal 2/3rds and distal 1/3rd proximately

  • PIN distally


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