Approaches for ORAL

Question 1

Volar russe

Answer 1

Setup:
supine, armboard, ? prep iliac crest

Superficial:
landmark the incision according to the tuberosity of the scaphoid and the FCR tendon.

Plane:
No inter-nervous plane - beware radial artery just radial to FCR!!!
Scaphoid lie just under the undersurface of the FCR sheath

Question 2

Deltopectoral

Answer 2

Deltoid Pec
Can do a clavicular osteotomy if axillary bleeding is uncontrolled
Injure axillary nerve at inferior border of subspace
Injure MSC at inferior medial coracoid, reenters biceps 5-8cm lateral to coracoid
Anterior circumflex humeral artery cephalad to pec major

Question 3

Posterior to shoulder

Answer 3

Teres Minor (ax) and Infraspinatus (Suprascapular)
Teres goes superiorly, infraspinatus inferiorly

Question 4

Deltopectoral, Anterior, Anterolateral, Back to anterior (to elbow)

Answer 4

Deltopectoral, extends to biceps and brachailis (split brachialis b/c med (MSC) lateral (RAD)
Distal BR and Brachialis (find RN here)
BR and PT

Question 5

Posterior to arm

Answer 5

Split triceps between long and lateral head

Danger! Watch radial nerve and profunda vessels in spiral groove

Question 6

For lateral condyle fractures you can do a lateral approach

Answer 6

Between Brachioradialis and triceps