Zlotolow et al. systematically review the surgical approaches to the proximal humerus, humeral shaft, and distal humerus, detailing the neurovascular anatomy — particularly the radial and axillary nerves — that governs approach selection and safe exposure limits for each humeral zone.
When planning humeral surgery, let fracture zone and nerve anatomy drive your approach: use the deltopectoral for proximal pathology, the lateral paratricipital (with radial nerve identification) for shaft and extensile exposures, and reserve olecranon osteotomy for the most comminuted intra-articular distal fractures where visualization outweighs the nonunion risk.
Always identify the radial nerve before working within 10 cm of the elbow joint posteriorly.
Zlotolow et al. systematically review the surgical approaches to the proximal humerus, humeral shaft, and distal humerus, detailing the neurovascular anatomy — particularly the radial and axillary nerves — that governs approach selection and safe exposure limits for each humeral zone.
When planning humeral surgery, let fracture zone and nerve anatomy drive your approach: use the deltopectoral for proximal pathology, the lateral paratricipital (with radial nerve identification) for shaft and extensile exposures, and reserve olecranon osteotomy for the most comminuted intra-articular distal fractures where visualization outweighs the nonunion risk.
Always identify the radial nerve before working within 10 cm of the elbow joint posteriorly.