Table of most common surgical approaches in orthopaedic surgery
REGION | APPROACH | EPONYM | MUSCULAR INTERVAL 1 | MUSCULAR INTERVAL 2 | DANGERS |
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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 |
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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 |
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Elbow | Anterolateral(Prox) |
| Brachialis (Median) | Brachioradialis (Radial) | Lat ABC A / radial N |
| Anterolateral(Distal) |
| Brachioradialis (Radial) | Pronator Teres (median) |
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| Posterolateral | Kocher | Anconeus (radial) | Ext carpi ulnaris (PIN) | PIN (diss to ann lig) |
| Medial |
| Brachialis (musculocutaneous) | Triceps / pron teres | Ulnar N |
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Forearm | Volar(Proximal) | Henry | Brachioradialis (radial) | Pron teres (median) | PIN |
| Volar(Distal) |
| Brachioradialis (radial) | FCR (Median) |
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| Dorsal(Proximal) | Thompson | ECRB (radial) | EDC (PIN) | PIN |
| Dorsal(Distal) |
| ECRB (radial) | EPL (PIN) |
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| Ulnar |
| ECU (PIN) | FCU (ulnar) | Ulnar N and A |
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Wrist | Dorsal |
| 3rd Compartment EPL (PIN) | 4th Compartmt EIP/EDC (PIN) | Radial N (superficial) |
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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 |
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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 |
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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 |
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Distal Femur | Posterior |
| Biceps Femoris (sciatic) | Vastus lateralis (femoral) | Sciatic N / PFCN |
REGION | APPROACH | EPONYM | MUSCULAR INTERVAL 1 | MUSCULAR INTERVAL 2 | DANGERS | |
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Hip | Anterior- | Smith-Peterson | Sartorius(Femoral nerve) | TFL(Sup Gluteal Nerve) | LFCN, Fem N. asc br LFCA | |
| Anterior – | 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 | |
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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 | Med sural cut N / tib N / peroneal N | |
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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 | |
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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 | |
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Med Mall | Posterior |
| Tibialis posterior (tibial) | FDL (tibial) | Post Tib Artery/Nerve | |
| Anterior |
| ——– | ——— | Saphenous N and V | |
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Lat Mall | Lateral |
| Peroneus tertius (deep peroneal) | Peroneus brevis (sup peron) | Sural N, Sup Peron Nerve | |
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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 |
Last Updated on June 27, 2024
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