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Common Orthopaedic Surgical Approaches

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


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