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Humerus shaft - Approach - Anterolateral transdeltoid approach for antegrade nailing - AO Surgery Reference Executive Editor: Chris Colton Authors: Pol Rommens, Peter Trafton Humerus shaft Search search... Shortcuts All Preparations All Approaches All Reductions & Fixations Anterolateral transdeltoid approach for antegrade nailing tissue sharply. sutures in the tendon. Skin incision Make a small skin incision from the anterolateral edge of the acromion, distally towards the deltoid insertion. Incise the subcutaneous Exposure of the humerus Split and retract between the deltoid muscle fibers. Incise the supraspinatus tendon in line with its fibers with pointed scalpel blade. Retract both edges with Expose a small part of the humeral head cartilage medial to the greater tuberosity. Insertion of guide pin Insert a guide pin through the opening made in the supraspinatus tendon, just at the lateral edge of the humeral articular cartilage, and confirm correct positioning in two planes, using image intensification. https://www2.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MS…terolateral%20transdeltoid%20approach%20for%20antegrade%20nailing 28/10/12 2:35 PM Page 1 of 2
Humerus shaft - Approach - Anterolateral transdeltoid approach for antegrade nailing - AO Surgery Reference<br />
Executive<br />
Editor: Chris<br />
Colton<br />
Authors: Pol<br />
Rommens, Peter<br />
Trafton<br />
Humerus<br />
shaft<br />
Search<br />
search...<br />
Shortcuts<br />
All Preparations<br />
All Approaches<br />
All Reductions &<br />
Fixations<br />
Anterolateral transdeltoid approach<br />
for antegrade nailing<br />
tissue sharply.<br />
sutures in the tendon.<br />
Skin incision<br />
Make a small skin incision<br />
from the anterolateral edge<br />
of the acromion, distally<br />
towards the deltoid<br />
insertion.<br />
Incise the subcutaneous<br />
Exposure of the humerus<br />
Split and retract between<br />
the deltoid muscle fibers.<br />
Incise the supraspinatus<br />
tendon in line with its fibers<br />
with pointed scalpel blade.<br />
Retract both edges with<br />
Expose a small part of the humeral head cartilage medial<br />
to the greater tuberosity.<br />
Insertion of guide pin<br />
Insert a guide pin through<br />
the opening made in the<br />
supraspinatus tendon, just<br />
at the lateral edge of the<br />
humeral articular cartilage,<br />
and confirm correct<br />
positioning in two planes, using image intensification.<br />
https://www2.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MS…terolateral%20transdeltoid%20approach%20for%20antegrade%20nailing<br />
28/10/12 2:35 PM<br />
Page 1 of 2
Humerus shaft - Approach - Anterolateral transdeltoid approach for antegrade nailing - AO Surgery Reference<br />
in the lateral view.<br />
Location of entry point<br />
The ideal entry point is<br />
situated medial to the<br />
greater tuberosity, which is<br />
lateral to the axis of the<br />
medullary canal in the AP<br />
view and in line with the axis<br />
Insert the guide pin into the proximal humerus.<br />
recommended.<br />
Opening entry portal<br />
Open the proximal end of<br />
the humerus using a<br />
cannulated awl. Insert it<br />
over the guide pin.<br />
An entry portal of about 12<br />
mm diameter is<br />
Pitfall: Damage to rotator<br />
cuff<br />
Access to the entry site is<br />
through the supraspinatus<br />
tendon.<br />
Damage to the rotator cuff is<br />
minimized by sharp incision.<br />
The edges of the incision are retracted by sutures held by<br />
clamps to avoid damage to the tendon.<br />
If reamers are used, they should be passed carefully<br />
through the tendon before reaming.<br />
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v1.0 2006-09-14<br />
https://www2.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MS…terolateral%20transdeltoid%20approach%20for%20antegrade%20nailing<br />
28/10/12 2:35 PM<br />
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