anterolateral

Shoulder

Approaches

 

Anterior

Anterolateral

Posterior

 

Anterior Approach / Deltopectoral

 

Indications

- shoulder stabilization

- arthroplasty

- fracture fixation

 

Approach

 

Position

- beach chair

- upper body elevated 30- 40o / reduces venous pressure and bleeding

Hip

Approaches

 

Anterior

Anterolateral

Lateral

Posterior

Medial

 

Anterior Approach / Smith Peterson

 

Indications

- neonatal hip sepsis

- open reduction hip DDH

 

Techique

 

Position

- supine

- sandbag under buttock

- free drape leg

 

Landmarks

Foot and Ankle

Approaches

 

Ankle

- anterior

- anterolateral

- posterolateral

 

Hindfoot

- lateral

- Ollier's

 

Anterior approach to Ankle

 

Concept

 

Between EHL and EDL

 

Indications 

- drainage of ankle joint

- ankle arthrodesis

- ORIF tibial plafond

- removal of loose bodies

 

Approach

 

Position 

Arthroscopy

Portals

 

1.  Anterolateral

 

Viewing portal

- 1cm lateral to patella tendon

- 1cm above joint line

- 1 cm below inferior pole patella

 

Problems

- too medial, in fat pad

- too high, limitation by patella, difficult to see posterior horns

- too low, damage anterior horn meniscus

 

Limitations

- PCL

- anterior horn LM

OCD

DefinitionTalus OCD MRI Coronal

 

Fracture talus through articular cartilage into subchondral bone

- 2° force transmitted from distal tibia

 

Osteochondritis dissecans v osteochondral fracture

 

Epidemiology

 

6% ankle sprains

Average age = 25 

M > F

 

Location