A MODIFICATION OF HENRYS ANTERIOR APPROACH TO THE HUMERUS

A retrospective chart review identified patients who had surgery throu gh Henry's standard anterior and anterolateral approaches to the humer us. Of the patients contacted 62% had problems with the skin incision with reports of pain, numbness, and tingling around the scar. The freq uency of cutaneous problems including neuroma prompted an anatomic stu dy; the lower lateral cutaneous nerve branches to the arm were dissect ed in seven cadaver arms to determine their course. Henry's incision w as then compared with a midline anterior incision. The cutaneous nerve s were noticeably less numerous and smaller in diameter in the midline incision, probably related to the internervous, or watershed zone of cutaneous nerves in the anterior midline of the arm. Henry's standard intermuscular humeral exposure was no more difficult with the anterior midline incision. This study supports the notion that an anterior mid line incision to approach the shaft of the humerus would minimize scar discomfort from cutaneous nerve injury.