Have you ever heard the concept "internervous plane?. This plane lies between muscles supplied by different peripheral nerves. These planes are helpful, mainly because they can be used [along their entire length] to approach bone or joints without a risk to denervate any of the involved muscles. Virtually all the traditional extensile surgical approaches to bone use internervous planes. For example; an anterior [deltopectoral] surgical approach to the shoulder will use the deltoid muscle, innervated by the axillary nerve and Pectoralis major, innervated by both medial and lateral pectoral nerves. In an anterior approach to the hip [Smith-Peterse], an internervous plane between the Sartorius muscle (femoral n) and the tensor fasciae latae (superior gluteal n.) is utilized.
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Scar from shoulder arthroplasty due to severe arthritis. | | | |
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AP shoulder X-ray showing a hemiarthroplasty. Identify the bony elements for practical purposes. |
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