-Usually requires osteotomy
Uses
-ORIF fx’s distal humerus
-Removal loose bodies
-Non-unions
Positioning
-Diving Board
-Prone
-Tourniquet
-Arm abducted 90 degrees
-Elbow flexed over side of table
Landmark - palpate olecranon process
Incision - 5cm incision over the olecranon process that is curvilinear. Start lateral and curve it medially at olecranon
Intervervous plane - None
Superficial Dissection
-ulnar nerve as it curves post to medial epicondyle (protect)
-osteotomy 2cm from tip (v-shaped)
Deep Dissection
-Elevate tricep from back humerus
-Beware of radial nerve as is passes from post to ant through the lat intermuscular septum
Dangers
-ulnar nerve - beware traction
-median nerve - ant to distal humerus
-radial nerve - if prox extension of approach
-brachial artery - with median nerve
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