Wednesday, July 8, 2009

Approaches - Anterior Lateral Approach to the Distal Humerus

Uses

-ORIF

-Exploration of Radial Nerve


Positioning

-Supine, arm abducted 60 deg, exsanguinate limb and use tourniquet


Landmark - biceps brachii and flexion crease of elbow


Incision - curved longitudinal on lat border of biceps, start 10cm prox to flexion crease and end at flexion crease


Internervous plane - Brachialis and brachioradialis are both innervated by radial nerve - although their innervation plays a minor role in motor function


Superficial Dissection

-Subq tissues

-ID lateral border biceps and retract medially

-ID interval between brachioradialis/brachialis

Deep Dissection

-ID and stay on medial side of radial nerve

-Retract brachialis medially


Dangers

-radial nerve

-musculocutaneous nerve

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