| Introduction |
- Indications
- Open reduction and internal fixation of distal humerus fractures (lateral condyle)
- Open treatment of lateral epicondylitis
- Internervous plane (none)
- Between the triceps (radial n.) and brachioradialis (radial n.)
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| Approach |
- Position
- Supine with arm lying across chest
- Incision
- Make a curved or straight incision over the lateral supracondylar ridge
- Superficial dissection
- Incise the deep fascia in line with the skin incision
- Identify the plane between the brachioradialis and triceps
- Cut in between these two muscles down to bone
- Reflect the triceps posteriorly and the brachioradialis anteriorly
- Deep dissection
- The common extensor origin can be released off the lateral humerus and the triceps can be similarly elevated posteriorly
- Extension
- Proximal extension cannot be obtained due to the radial nerve crossing proximally in line with the incision
- Distal extension can be obtained by extending into the interval between the anconeus (radial n.) and extensor carpi ulnaris (posterior interosseous n)
- This extension can only be carried to the radial head to avoid potential injury to the posterior interosseous nerve
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| Dangers |
- Radial nerve
- This nerve is at risk with proximal extension, as the nerve pierces the lateral septum in the distal third of the arm
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