3

DELTOID SPLITTING APPROACH

USES

This approach is used for anterior acromioplasties if they are done open. It is usually used for rotator cuff repairs and for fractures of the humerus where a rod(s) will be started proximally in the region of the greater tuberosity. Hoppenfeld calls this the lateral approach.

ADVANTAGES

This approach is easy, as it comes directly down on the pathology and can also be extended anteriorly and posteriorly by taking the deltoid off of the acromion subperiosteally.

DISADVANTAGES

This approach is limited inferiorly by the axillary nerve, which usually crosses below, 5 cm distal to the acromion. If the axillary nerve is cut, the entire anterior deltoid will be denervated and shoulder flexion will be markedly impaired. The nerve has been seen as high as within 4 cm of the acromion.

STRUCTURES AT RISK

The only significant structure at risk is the axillary nerve, but it is not a problem as long as distal splitting of the deltoid is limited to the safe zone.

TECHNIQUE

Related posts:

Plantar Metatarsal Head Approach Anterior Approach to the Distal Thigh and Femur Anterolateral Approach to the Tibia Deltopectoral Approach Posterior Approach Anterior Approach to the Cervical Spine

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