Anterolateral Approach (Henry’s)

Proximal part of the anterior (Henry) approach to the forearm extended to follow the radial nerve (white arrow)
Proximal part of the anterior (Henry) approach to the forearm extended to follow the radial nerve (white arrow). Its branches are the superficial radial nerve (blue arrow), the nerve to extensor carpi radialis brevis (yellow arrow) and the posterior interosseous nerve (black arrow). Image from C R, Naidu D, Ravi S, S D. A Case Report on Parosteal Lipoma Stretching the Posterior Interosseous Nerve Without Causing Palsy. Cureus. 2021, 13(4), e14776. CC BY 3.0.
Anterolateral Approach (Henry's), brachioradialis
Brachioradialis. Image by Henry Vandyke Carter, Wikimedia Commons, Public domain.

Indications

  • Exposure of lateral half of elbow joint
    • Capitellum
    • Proximal third of anterior aspect of radius
  • ORIF
  • Drainage
  • Decompression
    • Arcade of Frohse
    • PIN
  • Total elbow replacements

Position

  • Supine
  • Arm board

Landmarks

  • Brachioradialis (mobile wad)
  • Biceps tendon
  • Anterior elbow crease

Incision

  • 15 cm curved longitudinal gentle S shaped incision along anterior aspect of elbow
  • Start: 5cm above elbow crease over lateral border of biceps
  • Cross elbow crease obliquely
  • End: medial border of brachioradialis

Internervous Plane

Superficial Dissection

  • Identify & protect lateral cutaneous nerve of forearm
    • Becomes superficial in distal 5 cm of arm
    • Lateral to biceps tendon
    • Between biceps & brachialis
  • Incise fascia on medial side of BR
  • Develop interval between BR & brachialis using blunt dissection
  • Identify & protect radial nerve at elbow
    • Lives between BR & Brachialis
    • Follow it distally til its 3 branches
      • PIN
      • Superficial radial nerve
      • Branch to ECRB
  • Below division of nerve
    • Develop plane between BR & PT
  • Ligate recurrent branches of radial artery
  • Retract radial artery laterally

Deep Dissection

  • Incise anterior capsule between
    • Laterally radial nerve
    • Medially brachialis
  • Fully supinate the forearm to expose insertion of supinator
  • Incise origin of supinator staying lateral to insertion of biceps

Dangers

  • Nerves
    • Radial
    • PIN
    • Lateral cutaneous nerve of forearm
  • Vessels
    • Radial artery
    • Recurrent branches of radial artery

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.