Wednesday, April 24, 2013

What is an internervous planes?


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.


Scar from shoulder arthroplasty due to severe arthritis.    
AP shoulder X-ray showing a hemiarthroplasty. Identify the bony elements for practical purposes.

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