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Related Experiment Video

Updated: Jan 20, 2026

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
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The modified anterolateral approach to the humerus.

Angela Christine Chang1,2, Ngoc Buu Ha2, Christopher Sagar2

  • 11 The University of Adelaide, Adelaide, Australia.

Journal of Orthopaedic Surgery (Hong Kong)
|August 20, 2019
PubMed
Summary

This study presents a modified anterolateral approach (ALA) for humeral shaft fractures, preserving brachialis muscle fibers. The modified ALA offers a less muscle-destructive surgical option with satisfactory patient outcomes.

Keywords:
brachialisdeep headhumerusmodified anterolateral approachsuperficial head

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Area of Science:

  • Orthopedic Surgery
  • Surgical Anatomy
  • Musculoskeletal Trauma

Background:

  • Traditional anterolateral approaches to the humerus involve longitudinal splitting of the brachialis muscle.
  • Recent anatomical studies reveal brachialis fibers run obliquely, making longitudinal splitting muscle-destructive.

Purpose of the Study:

  • To present a modified anterolateral approach (ALA) that minimizes brachialis muscle fiber damage.
  • To evaluate the clinical and radiological outcomes of this modified ALA for humeral shaft fractures.

Main Methods:

  • A modified ALA was developed, elevating the superficial brachialis head and splitting the deep head longitudinally.
  • Retrospective review of case notes for patients with humeral shaft fractures treated with the modified ALA.

Main Results:

  • Nineteen humeral shaft fractures were treated with the modified ALA.
  • No post-operative nerve palsies occurred; 73.7% had clinical and radiological follow-up.
  • 14 patients reported satisfaction; one superficial infection and one non-union occurred.

Conclusions:

  • The modified ALA, based on improved brachialis anatomy, is less muscle-destructive.
  • This approach follows a more accurate inter-nervous plane, demonstrating satisfactory outcomes in this series.