肘关节外侧入路.doc

肘关节外侧入路?? 2011-11-23 15:52:02|??分类： 手术入路 |??标签： |举报 |字号大中小?订阅 Skin incision The incision starts over the lateral supracondylar ridge, 5 cm proximal to the elbow joint. It passes distally to the lateral surface of the proximal forearm, posterior to the radial head.NoteBe careful of the radial nerve, which runs close to the radial head and neck. It divides into its superficial and deep branches at the level of the radial head. Deep dissection The deep fascia is incised in line with the skin incision.?? ? ? The lateral humeral epicondyle is exposed by developing the interval between the triceps muscle posteriorly, and the brachioradialis and extensor carpi radialis longus anteriorly.The dissection is continued distally between the extensor carpi ulnaris and the anconeus muscles. The red line marks the site of the capsulotomy, which is shown in the next step. ? Opening the joint The joint capsule is incised longitudinally from the distal part of the lateral humeral epicondyle, over the capitellum and then over the postero-lateral aspect of the radial head.Alternatively, the capsule can be incised as a proximally based U-shaped flap. ? ? ? The exposure of the capitellum and the radial head is seen in this photograph.  Further exposure Subperiosteal reflection of the brachioradialis and extensor carpi radialis longus anteriorly, and the triceps posteriorly will improve joint exposure. NoteBe careful when placing the anterior retractor as the radial nerve is at risk. ?