Surgical Discussion

Patient positioning:  Prone

Anatomical surgical approach:  Some strange aggregate lateral approach

This case is going back several years, and in retrospect i approached this in the most idiotic way - trying to turn a posterolateral paratricipital approach, into what ill call an aggregate lateral approach, with the patient prone. I started this under the false beliefe that from an anterior approach i wouldnt be able to fully mobilise, and decompress the radial nerve. This approach started posterolaterally, elevating a lateral paratricipital window and progressed proximally to deltoid. i then develloped a deltopectoral window anterior to deltoid (with some sharp elevation of the deltoid insertion anteriorly) to get to the lateral aspect of the head/tuberosity. whilst prone. this sucked. Next time - aggregate anterior approach, supine/semi-beachchair. if not wanting to split brachialis or wanting to minimise deltoid trauma - twist the plate.