Forearm surgical approaches

Surface anatomy of forearm

Forearm surgical approaches

• Anterior approach (Henry)• Posterolateral approach (Thompson)• Ulnar approach

Anterior approach (Henry)

Deep dissection: proximal third

Deep dissection: middle third

Deep dissection: distal third

Deep dissection: distal third

Deep dissection: distal third (modified Henry approach)

Deep dissection: distal third (modified Henry approach)

Deep dissection: distal third (modified Henry approach)

Posterolateral approach (Thompson)

Deep dissection – middle third

Deep dissection – middle third

Deep dissection – middle third

Deep dissection – middle third

Deep dissection – extension to proximal third

Deep dissection – extension to proximal third

Distal extension

Ulnar approach

Approach Interval Structures at risk

Anterior (Henry) Brachioradialis (radial nerve) and pronator trees (median nerve) Distally-flexor capo radialis (median nerve)

Legate leash of Henry (radial artery branches)Superficial branch of radial nerve

Dorsal posterior (Thompson)

Extension capi radialis bevis (radial nerve) and extensor digitorum communis (PIN)

Posterior interosseous nerve (PIN) –avoid excessive retraction of supinator

Ulnar Extension carpi ulnaris (PIN) and flexor carpi ulnaris (Ulnar nerve)

Summary

Thank you