Executive Editor: Peter Trafton, Michael Baumgaertner

Authors: Peter Kloen, David Ring

Proximal forearm

back to skeleton


Safe zones


Inserting percutaneous instrumentation through safe zones reduces the risk of damage to neurovascular structures.

Safe zones humerus midshaft enlarge

Safe zone in the humerus distal third

Schanz screws are inserted from an anterolateral or posterolateral direction through the triceps muscle.

Avoid penetration of the olecranon fossa. Due to the risk of nerve or vascular injury, the tips of the Schanz screws should just perforate the far cortex.

Safe zones humerus enlarge

Safe zone in the humerus middle third

In the proximal third of the middle shaft, Schanz screws can be inserted anterolaterally.

Avoid Schanz screw placement distal to this point as the radial nerve is at risk.

Safe zones proximal forearm enlarge

Safe zone in the proximal forearm

With the forearm in neutral position, Schanz screws are inserted into the lateral or posterolateral part of the proximal or middle third of the ulna.

It is an easily recognizable and palpable bone. Carefully check pronation and supination after insertion to make sure the Schanz screw does not affect the radius.

v2.0 2018-04-30