Master Tech Ortho Surgery Elbow CH1

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PART I Exposures

side of the radius (Fig. 1C-3). The bare shaft of the radius between the supinator and pronator attachments is well defined (Fig. 1C-4). ●● Proximally with the forearm in supination, the supinator muscle is noted and the posterior interos- seous nerve observed and may or may not be exposed. ●● The supinator muscle either is then released in its midportion exposing the posterior interosseous nerve or, more commonly, is released from the shaft of the radius (Fig. 1C-5). ●● Pearls: This is facilitated by fully supinating the forearm, which brings the supinator attachment of the radius easily within the wound, allowing excellent visualization for the release of its origin. ●● It is not necessary to identify the posterior interosseous nerve during this procedure, but one should be gentle to avoid nerve injury. ●● The supinator muscle is reflected toward its ulnar attachment, and the proximal portion of the radius is exposed (Fig. 1C-6).

Extensor digitorum communis

Extensor carpi radialis longus

Extensor carpi radialis brevis

Bare area of radius Supinator

Pronator teres

Abductor pollicis longus

Extensor pollicis brevis

B

FIGURE 1C-2

FIGURE 1C-3