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ORIGINAL ARTICLE
Year : 2016  |  Volume : 51  |  Issue : 2  |  Page : 180-185

Lateral approach to the humeral shaft: approach for special situations


Department of Orthopedic Surgery, Mansoura University Hospitals, Mansoura, Egypt

Correspondence Address:
Hatem S.A. Elgohary
Department of Orthopedic Surgery, Mansoura University Hospitals, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1148.203153

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Background In situations where simultaneous exploration of the anterior, the lateral, and the posterior surfaces of the shaft of the humerus is needed, or when radial nerve exploration is required, it is beneficial to find an approach that allows good exposure of the humeral surfaces and good exploration of the radial nerve. The objective of this study was to assess the results of using the lateral approach of the humerus in such situations. Patients and methods Between January 2008 and December 2010, 18 displaced humeral shaft fractures in 18 patients were treated in Mansoura University Hospitals with open reduction and plate fixation using lateral approach. Fractures were classified according to the OTA classification, and preoperative and postoperative assessments of the radial nerve were done. The follow-up included assessment of the range of motion of shoulders, elbows, and wrists; the muscular strength of the shoulders; and hand grip were assessed as compared with the other uninjured side. Results All fractures healed within a mean time of 14 weeks (11–17 weeks). Of 11 patients with preoperative radial nerve palsy, nine (82%) had complete spontaneous recovery within few months after surgery, and the other two had near-complete recovery. There was one case of superficial infection that resolved after wound debridement and antibiotic therapy. No patient had delayed union, nonunion, or implant failure. Conclusion Lateral approach for the humerus is an excellent way for radial nerve exploration and for cases where the lateral, the anterior, and the posterior surfaces of the humerus needed to be approached simultaneously. This approach allows supine positioning of the multiply injured patients and proper visualization of the radial nerve without muscle splitting; however, it does not allow exploration of the radial nerve in the proximal third of the humerus.


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