Master Tech Ortho Surgery Elbow CH1
1 Exposures of the Upper Extremity: Humerus, Elbow, Forearm
●● The skin and subcutaneous tissue are incised exposing the brachial fascia, which is likewise incised. Beginning proximally, the medial margin of the deltoid is defined along with the cephalic vein. ●● The deltopectoral groove is developed by blunt and sharp dissection. ●● The deltoid is retracted laterally and the pectoralis major medially. This exposes the long head of the biceps tendon, and deep in the interval, the pectoralis major attachment to the proximal humerus is visualized. Note : The inferior humeral attachment of the pectoralis major is the proximal limit of the exposure. ●● The proximal margin of the pectoralis is retracted, exposing the circumflex vessels. Release of the attachment allows access to the proximal major attachment portion of the humeral shaft (Fig. 1A-3A and B). ●● Retracting the deltoid laterally and the pectoralis major medially allows ready access to the proxi- mal humeral shaft distal to the subscapularis muscle and lateral to the long head of the biceps tendon.
Made with FlippingBook - Online magazine maker