Posterior approach to the Humerus

Indications

ORIF
Osteomyelitis
Exploration of radial nerve

Position

Lateral
Axillary roll

Landmarks

Acromion
Olecranon fossa

Incision

Longitudinal midline incision
Start: 8cm below acromion
End: olecranon fossa

Internervous Plane

Triceps splitting approach
- Medial head of triceps supplied by
  - Radial nerve
  - Ulnar nerve

Superficial Dissection

Deep fascia
Triceps
- Superficial
  - Lateral head
    - Lateral lip of spiral groove
  - Long head
    - Infraglenoid tubercle
- Deep
  - Medial head
    - Below spiral groove
Ligate many blood vessels

Deep Dissection

Incise medial head in midline
Subperiosteal dissection

Dangers

Nerve
- Radial nerve
- Ulnar nerve
Vessels
- Profunda brachii artery