AOTrauma Webinar:  Why Do Patients Get Infection?

May 30, 2017 14:00 CET

Main Presenter: Olivier Borens, MD (Switzerland)
Chat Moderator: Stephen Kates, MD (USA)

Surgical site infections after trauma are debilitating and costly. They are feared by the surgeon and the patient alike. The incidence of this complication can be decreased by proper preoperative, intraoperative, and postoperative management.
The goal of this webinar is to present easy-to-use tools and strategies that will lead to a decrease in the incidence of infection.

More information and registration...

Infection

Executive Editor: Chris Colton

Authors: Mariusz Bonczar, Daniel Rikli, David Ring

Distal humerus

back to skeleton

Glossary

Lateral approach
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Skin incision

The incision starts over the lateral supracondylar ridge, 5 cm proximal to the elbow joint. It passes distally to the lateral surface of the proximal forearm, posterior to the radial head.
Note
Be careful of the radial nerve, which runs close to the radial head and neck. It divides into its superficial and deep branches at the level of the radial head.


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Deep dissection

The deep fascia is incised in line with the skin incision.


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This image shows the incision in the deep fascia.


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The lateral humeral epicondyle is exposed by developing the interval between the triceps muscle posteriorly, and the brachioradialis and extensor carpi radialis longus anteriorly.
The dissection is continued distally between the extensor carpi ulnaris and the anconeus muscles. The red line marks the site of the capsulotomy, which is shown in the next step.


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Opening the joint

The joint capsule is incised longitudinally from the distal part of the lateral humeral epicondyle, over the capitellum and then over the postero-lateral aspect of the radial head.
Alternatively, the capsule can be incised as a proximally based U-shaped flap.


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The exposure of the capitellum and the radial head is seen in this photograph.


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Further exposure

Subperiosteal reflection of the brachioradialis and extensor carpi radialis longus anteriorly, and the triceps posteriorly will improve joint exposure.

Note
Be careful when placing the anterior retractor as the radial nerve is at risk.

v1.0 2016-10-21