Extensile approach to the anterolateral surface of the humerus and the radial nerve

A proposed approach to the anterolateral surface of the humeral shah that w ould allow for exploration of the radial nerve was studied in 30 cadaver ar ms. The incision starts proximally along the posterior border of the deltoi d muscle and extends anteriorly and distally over the lateral border of the biceps muscle. A deep dissection is made in the internervous plane between the deltoid and the triceps muscles proximally and between the longitudina lly split fibers of the brachialis muscle distally The approach provides ac cess to the anterolateral surface of the humerus vp to the level of the axi llary nerve and the posterior circumflex humeral vessels. The insertion of the deltoid muscle into the anterior border of the humerus is preserved and the radial nerve is protected by the triceps muscle proximally and by the retracted lateral portion of the brachialis muscle distally. The entire cou rse of the radial nerve in the arm can be exposed. Proximally, the radial n erve can be exposed by elevating the lateral head of the triceps muscle fro m the humerus. Distally, the radial nerve can be exposed between the brachi oradialis and the brachialis muscles, A plate can be applied on the anterol ateral surface of the humerus without having to elevate the firmly attached anterior deltoid insertion.