Indications
- Insertion of humeral nail
Principles
- Entry point
- Lateral to articular surface of humeral head
- Medial to greater tuberosity
Position
- Supine
- Beach chair 60°
- Shoulder is over edge of table
- Mayfield head rest
- Image intensifier
Landmarks
- Acromion
Incision
- 2cm longitudinal incision
- Start: outer aspect of acromion
Internervous Plane
- Deltoid splitting
- Axillary nerve
Superficial Dissection
- Insert guide wire under II control
- Cut down onto wire with scalpel through deltoid & supraspinatus
Dangers
- Nerves
- Axillary
- Tendons
- Supraspinatus