Anterior approach to the proximal forearm
1. Introduction
The anterior approach can be used to access the bicipital tuberosity of the radius and/or the radial neck/metaphysis.
2. Skin incision
A curved incision over the anterior aspect of the elbow is performed, starting 5 cm above the flexion crease on the lateral side of the biceps.
Curve the incision over the front of the elbow. It ends on the medial border of the brachioradialis.
3. Surgical dissection
Identify and protect the posterior interosseous branch (PIN) of the radial nerve at the lateral margin of the brachialis muscle. Carefully follow this branch into the supinator muscle.
Split the fascia and ligate the recurrent radial artery.
Further deep dissection exposes the bicipital tuberosity of the radius or the radial neck.
If this approach is used for reattachment of the biceps tendon, release and reflect the supinator carefully, protecting the PIN, display the tuberosity by full supination.
4. Closure
The wound is closed in layers.
