Gardner et al. describe the anterolateral acromial (ALA) approach for surgical fixation of displaced proximal humerus fractures, detailing step-by-step technique and reporting early clinical outcomes in 52 patients treated over 4 years. The study asks whether deliberate axillary nerve identification and lateral deltoid splitting can provide adequate fracture access while protecting neurovascular structures.
When plating a displaced proximal humerus fracture, the ALA approach gives you a direct lateral window to the plating zone without crossing the anterior humeral circumflex vessels — and mandates axillary nerve identification, which may uncover occult nerve entrapment at the fracture site that would otherwise go untreated.
Gardner et al. describe the anterolateral acromial (ALA) approach for surgical fixation of displaced proximal humerus fractures, detailing step-by-step technique and reporting early clinical outcomes in 52 patients treated over 4 years. The study asks whether deliberate axillary nerve identification and lateral deltoid splitting can provide adequate fracture access while protecting neurovascular structures.
When plating a displaced proximal humerus fracture, the ALA approach gives you a direct lateral window to the plating zone without crossing the anterior humeral circumflex vessels — and mandates axillary nerve identification, which may uncover occult nerve entrapment at the fracture site that would otherwise go untreated.