Table of most common surgical approaches in orthopaedic surgery
REGION
|
APPROACH
|
EPONYM
|
MUSCULAR INTERVAL 1
|
MUSCULAR INTERVAL 2
|
DANGERS
|
|
|
|
|
|
|
Shoulder
|
Anterior
|
|
Deltoid (axillary)
|
Pec Major (med / lat pec)
|
MC N/Axillary N/ceph V
|
|
Lateral
|
|
Deltoid (splitting) (axillary)
|
Deltoid (splitting) (axillary)
|
Axillary N
|
|
Posterior
|
|
Infraspinatus (Suprascap)
|
Teres minor (axillary)
|
Ax N / post cir hum A
|
|
|
|
|
|
|
Humerus
|
Anterolateral(Proximal)
|
|
Deltoid(Axillary)
|
Pec Mjr(med/lat pectoral)
|
Axillary N / ant cir hum A
|
|
Anterolateral(Distal)
|
|
Medial fibers Brachialis(MC)
|
Lat fibers Brachialis(Radial)
|
Radial Nerve
|
|
Posterior
|
|
Split heads of triceps (radial)
|
|
Radial N / Ulnar nerve
|
|
|
|
|
|
|
Elbow
|
Anterolateral(Prox)
|
|
Brachialis (Median)
|
Brachioradialis (Radial)
|
Lat ABC A / radial N
Radial Recurrent AV
|
|
Anterolateral(Distal)
|
|
Brachioradialis (Radial)
|
Pronator Teres (median)
|
|
|
Posterolateral
|
Kocher
|
Anconeus (radial)
|
Ext carpi ulnaris (PIN)
|
PIN (diss to ann lig)
|
|
Medial
|
|
Brachialis (musculocutaneous)
|
Triceps / pron teres
(radial / median)
|
Ulnar N
|
|
|
|
|
|
|
Forearm
|
Volar(Proximal)
|
Henry
|
Brachioradialis (radial)
|
Pron teres (median)
|
PIN
|
|
Volar(Distal)
|
|
Brachioradialis (radial)
|
FCR (Median)
|
|
|
Dorsal(Proximal)
|
Thompson
|
ECRB (radial)
|
EDC (PIN)
|
PIN
|
|
Dorsal(Distal)
|
|
ECRB (radial)
|
EPL (PIN)
|
|
|
Ulnar
|
|
ECU (PIN)
|
FCU (ulnar)
|
Ulnar N and A
|
|
|
|
|
|
|
Wrist
|
Dorsal
|
|
3rd Compartment EPL (PIN)
|
4th Compartmt EIP/EDC (PIN)
|
Radial N (superficial)
|
|
|
|
|
|
|
Scaphoid
|
Volar
|
Russe
|
FCR or through sheath (median)
|
Radial A
|
Radial A
|
|
Dorsolateral
|
Matti
|
1st compartment (PIN)
|
3rd compartment (PIN)
|
Sup rad N / radial A
|
|
|
|
|
|
|
Iliac Crest
|
Posterior
|
|
Gluteus maximus (inf gluteal)
|
Latissimus dorsi (thoracodorsal)
|
Clunial N, SGA, Sciatic N
|
|
Anterior
|
|
TFL / glut med & min(sup gluteal)
|
Ext abd oblique (segmental)
|
ASIS / LFCN
|
|
|
|
|
|
|
Thigh
|
Lateral
|
|
Vastus lateralis (femoral)
|
Vastus lateralis (femoral)
|
Perf br of profundus
|
|
Posterolateral
|
|
Vastus lateralis (femoral)
|
Hamstrings (sciatic)
|
Perf br of profundus
|
|
Anteromedial
|
|
Rectus femoris (femoral)
|
Vastus medialis (femoral)
|
Med sup geniculate A
|
|
|
|
|
|
|
Distal Femur
|
Posterior
|
|
Biceps Femoris (sciatic)
|
Vastus lateralis (femoral)
|
Sciatic N / PFCN
|
REGION
|
APPROACH
|
EPONYM
|
MUSCULAR INTERVAL 1
|
MUSCULAR INTERVAL 2
|
DANGERS
|
|
|
|
|
|
|
Hip
|
Anterior-
Superficial
|
Smith-Peterson
|
Sartorius(Femoral nerve)
|
TFL(Sup Gluteal Nerve)
|
LFCN, Fem N. asc br LFCA
|
|
Anterior -
Deep
|
Smith-Peterson
|
Rectus femoris(femoral)
|
Gluteus medius (sup gluteal)
|
Same
|
|
Anterolateral
|
Watson-Jones
|
Tensor fasciae latae (sup gluteal)
|
Gluteus medius (sup gluteal)
|
Fem NAV / Profunda A
|
|
Lateral
|
Hardinge
|
Splits glut Med (sup gluteal)
|
Splits vastus lat (femoral)
|
Fem NAV / LF Circ artery
|
|
Posterior
|
Southern Moore
|
Splits glut Max (inf gluteal)
|
N/A
|
Sciatic N, inf glut A
|
|
Medial- Superficial
|
Ludloff
|
Add longus (Ant div obturator)
|
Gracilis (Ant div obturator)
|
Ant div obt N / MFCA
|
|
Medial- Deep
|
Ludloff
|
Add brevis (ant div obturator)
|
Add magnus(Obtur/Tibial)
|
Same
|
|
|
|
|
|
|
Knee
|
Med Parapatellar
|
|
Vastus medialis (femoral)
|
Rectus Femoris(Femoral)
|
Infrapatellar br saph Nerve
|
|
Medial
|
|
Vastus medialis (femoral)
|
Sartorius (femoral)
|
Infrapat br saph N, MCL
|
|
Lateral
|
|
Iliotibial band (sup gluteal)
|
Biceps femoris (sciatic)
|
Peroneal N / popliteus ten.
|
|
Posterior
|
|
Semimemb / Medial gastroc (tibial)
|
Biceps / lateral gastroc
(Tibial)
|
Med sural cut N / tib N / peroneal N
|
|
|
|
|
|
|
Tibia
|
Posterolateral
|
|
GS, soleus, FHL (tibial)
|
Peroneus brev/long(sup peron)
|
Lessser saph V / Post tib A
|
|
Anterior
|
|
Tibialis anterior (Deep peroneal)
|
Periosteum
|
Long saph V
|
|
|
|
|
|
|
Ankle
|
Anterior
|
|
EHL (deep peroneal)
|
EDL (deep peroneal)
|
Sup and Deep peroneal N / Ant tib Artery
|
|
Posteorlateral
|
|
Peroneus brevis (sup peroneal)
|
FHL (tibial)
|
Sural N / Short saph V
|
|
Posteromedial
|
|
FHL
|
Peroneals
|
Post Tib Artery/Nerve
|
|
|
|
|
|
|
Med Mall
|
Posterior
|
|
Tibialis posterior (tibial)
|
FDL (tibial)
|
Post Tib Artery/Nerve
|
|
Anterior
|
|
--------
|
---------
|
Saphenous N and V
|
|
|
|
|
|
|
Lat Mall
|
Lateral
|
|
Peroneus tertius (deep peroneal)
|
Peroneus brevis (sup peron)
|
Sural N, Sup Peron Nerve
|
|
|
|
|
|
|
Foot
|
Anterolateral
|
|
Peroneal muscles (sup peroneal)
|
EDC/per tertius (deep peron)
|
Deep per N / ant tib A
|
|
Posteromedial
|
|
Tibialis posterior or FDL (tibial)
|
FDL or FHL (tibial)
|
Post tib A / N
|
|
1 Comment
Hide/Show CommentsJul 04, 2007
Christian Veillette
Great summary of the surgical approaches.
This table could serve as a starting point for separate pages for each muscle, nerve, artery, vein.
I would recommend that hyperlinks be created to new pages with details on the various anatomical structures. Make sure that the full name of the muscle, nerve, artery, vein is placed in the Link field. The abbreviated name should stay in the Alias field so the table format remains unchanged.