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Humerus - Approaches

Anterolateral Approach Posterior Approach
Anteromedial Approach Deltopectoral Approach
Humerus Anterior Muscles Anatomy Humerus Posterior Muscle Anatomy
Arm Cross Sections Arm Neurovascular Anatomy
Arm Anatomy Humerus Bony Anatomy
Arthrex

Anterolateral Approach

  • Adequate for: proximal 1/3, midshaft fx,distal 1/3 fx,
  • Postion: supine or modified beach chair
  • Incision: longitudinal just lateral to biceps.
  • Proximal exposure between deltoid and pec major insertions.
  • Distal exposure splits brachialis origin off humerus with medial retraction of biceps muscle.
  • Extension: can be extended into deltopectoral approach to the proximal humerus.
  • Risks: Radial nerve, lateral antebrachial cutaneous nerve, cephalic vein.
  1. Cephalic vein
  2. Lateral antebrachial cutaneous nerve
  3. Radial nerve
  4. Brachialis origin

Posterior Approach

  • Adequate for: midshaft fx,distal 1/3 fx, radial nerve palsy
  1. Lateral Brachial cutaneous nerve
  2. Radial nerve
  3. Profunda brachii artery
  4. Triceps - medial (deep) head
  5. Ulnar nerve
Anteromedial Approach
  • Rarely used
  • Anteromedial incision proximal to medial epicondyle
  • Dissection posterior to intermuscular septum
  • Ulnar nerve freed from triceps and reflected medially.
  • Median nerve and brachial artery reflected laterally.
  • Risks: Ulnar nerve, median nerve, brachial artery.
  1. Ulnar nerve
  2. Brachial artery and veins
  3. Median nerve
  4. Cephalic vein
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