Authors of section

Authors

Andrew Howard, Theddy Slongo, Peter Schmittenbecher

Executive Editor

James Hunter

General Editor

Fergal Monsell

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ESIN entry point (distal ulna)

1. Distal medial entry point

Use an image intensifier to determine the correct entry point.

This lies on the medial side of the ulna, 1 cm proximal to the growth plate.

Start the skin incision at the level of the entry point and extend it 2 cm distally.

ESIN - Distal medial entry point to the ulna

Use small scissors or a surgical clip and small retractors to dissect to the bone under direct vision.

Be careful not to injure the dorsal branch of the ulnar nerve or the basilic vein.

ESIN - Distal medial entry point to the ulna

2. Wound closure

Close skin and subcutaneous tissue with fine resorbable sutures (this avoids distress to the child when removing nonabsorbable sutures).