Surgical Approaches
A surgeon is teaching trainees about the anterior deltopectoral approach to the shoulder for proximal humerus fracture fixation. She emphasizes the importance of understanding the internervous plane, protecting the cephalic vein, and knowing the safe distances to the axillary and musculocutaneous nerves. She demonstrates the approach, discussing the options for subscapularis management and the common structures at risk. The trainees ask about when to take the cephalic vein laterally versus medially. Regarding the anterior deltopectoral approach to the shoulder:
Mark each as TRUE or FALSE
The deltopectoral approach utilizes an INTERNERVOUS PLANE between DELTOID (axillary nerve) and PECTO...
The AXILLARY NERVE is at risk 5-7cm distal to the lateral acromion (or 5cm inferior to coracoid); it...
The internervous plane is between deltoid and trapezius; the cephalic vein should always be taken ME...
The MUSCULOCUTANEOUS NERVE enters coracobrachialis 3-8cm (average 5cm) distal to the coracoid tip; t...
SUBSCAPULARIS MANAGEMENT options include: PEEL (subperiosteal elevation; healing 70-80%), LESSER TUB...
Answer the questions to see explanations
Click T (True) or F (False) for each option