You are here

Humeral Shaft Approaches

Anterolateral Approach

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

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

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

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer