Surgical approaches to upper limb

OVERVIEW

Surgical Approaches to Upper Limb – Hands-on Cadaver Workshop
Conducted on August 2, 2025, this intensive hands-on cadaveric dissection workshop was jointly organized by the Department of Orthopaedics and the Department of Anatomy. Designed to bridge operative orthopedic procedures with detailed sectional anatomy, the program provided structured training in classic and extensile surgical approaches across the shoulder, arm, elbow, forearm, wrist, and hand.

The workshop enrolled 20 postgraduate orthopedic residents, offering dedicated workstation access, fresh/embalmed cadaveric specimens, and individualized surgical mentorship under senior orthopedic faculty and anatomical experts.

Key Highlights & Dissection Goals
Postgraduates engaged in live knife-to-skin anatomical exposures, exploring internervous and intermuscular planes to ensure anatomical preservation and optimal fracture exposure.

Comprehensive Extremity Coverage – Shoulder girdle, arm, elbow joint, forearm, and wrist
Internervous Planes – Dissection along true anatomical safe intervals to safeguard neurovascular bundles
Orthopaedics & Anatomy Collaboration – Seamless integration of trauma surgery and structural dissection
Focused Cohort – 20 PG students ensuring optimal table time and tactile dissection experience
Neurovascular Preservation – Real-time identification of radial, median, ulnar, and axillary nerves

All cadaveric specimens were managed and prepared in strict compliance with ethical and institutional anatomical protocols, providing realistic surgical exposure and tactile feedback indispensable for live trauma cases.

COURSE DETAILS

Structured 1-Day Intensive Cadaveric Dissection (02/08/2025)
The single-day curriculum combined prosected demonstrations, orthopedic approach lectures, operative technique discussions, and extensive wet-lab surgical dissection.

The morning sessions focused on the shoulder girdle and humerus, including the deltopectoral and posterior approaches, while protecting the axillary and radial nerves. The afternoon sessions progressed to the elbow, volar and dorsal forearm exposures (Henry and Thompson approaches), and decompression of the carpal tunnel and Guyon canal.

Surgical Approach Modules & Timetable

Session 1: Shoulder & Humerus | Session 2: Elbow Joint Complex | Session 3: Forearm, Wrist & Hand
Deltopectoral approach to shoulder | Posterior approach to elbow (triceps split/sparing) | Henry’s anterior approach to radius
Anterolateral & posterior approaches to humerus | Medial & lateral approaches (Kocher interval) | Thompson’s dorsolateral approach
Axillary nerve & anterior circumflex identification | Ulnar nerve anterior transposition exposure | Volar approach to distal radius (Henry/modified)
Radial nerve tracing along the spiral groove | Radial head & coronoid process visualization | Carpal tunnel release & Guyon canal exposure

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SUBJECTS COVERED

Core Surgical Approaches Curriculum
Delegates systematically executed operative exposures on cadaveric upper limbs under direct proctoring from senior orthopedic faculty:

Module 1: Shoulder Girdle & Deltopectoral Approach

Incision along the cephalic vein interval between deltoid and pectoralis major. Exposure of the coracoid process, conjoined tendon mobilization, subscapularis tenotomy, and anterior glenohumeral exposure while protecting the musculocutaneous and axillary nerves.

Module 2: Humeral Shaft Exposures (Anterior & Posterior)

Anterolateral approach utilizing the plane between biceps and brachialis, splitting brachialis to reach the anterior humerus. Posterior triceps-splitting approach to the midshaft humerus with formal mobilization and protection of the radial nerve in the spiral groove.

Module 3: Elbow Joint Approaches (Medial, Lateral & Posterior)

Lateral approach through the Kocher interval (extensor carpi ulnaris and anconeus) for radial head and capitellum access. Medial approach with in-situ ulnar nerve release. Posterior triceps-reflecting approach (Bryan-Morrey) for distal humerus intra-articular fractures.

Module 4: Forearm Shaft Approaches (Henry & Thompson)

Volar Henry approach exploiting the internervous line between brachioradialis (radial nerve) and pronator teres / FCR (median nerve). Dorsolateral Thompson approach between EDC and ECRB to access the middle and proximal third of the radius with posterior interosseous nerve (PIN) protection.

Module 5: Distal Radius, Wrist & Hand Decompressions

Modified Henry approach to the distal radius volar plate, opening the space of Parona, releasing the pronator quadratus, along with safe extended carpal tunnel decompression protecting the recurrent motor branch of the median nerve.

Anatomists demonstrated cross-sectional relations and fascial compartments, reinforcing deep anatomical landmarks relevant to trauma, internal fixation, and elective reconstructions.

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COURSE REQUIREMENTS

Eligibility & Workshop Guidelines
Designed to build confidence and technique in surgical exposures for postgraduates and early-career orthopedic surgeons.

Target Audience

Postgraduate orthopedic residents pursuing MS (Orthopaedics) or DNB (Orthopaedics) and trauma fellows.

Lab Infrastructure

Standard orthopedic surgical instrument trays, self-retaining retractors, bone levers (Hohmanns), and dissection sets.[/fusion_content_box title="Certification" backgroundcolor="" icon="fusion-li-icon university-globe" iconflip="" iconrotate="" iconspin="no" iconcolor="" circlecolor="" circlebordersize="" circlebordercolor="" outercirclebordersize="" outercirclebordercolor="" image="" image_id="" image_max_width="35" link="https://snmcacsl.in/admissions/" linktext="Read More" link_target="" animation_type="" animation_direction="left" animation_speed="0.1" animation_offset=""] Official certificate issued jointly by the Department of Orthopaedics and Department of Anatomy with CME credit hours.

Each station received orientation regarding surgical ergonomics, soft tissue handling, safe plane development, and cadaveric tissue management prior to knife-to-skin dissection.

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WORKSHOP FACULTY & ORGANIZERS

DEPARTMENT OF ORTHOPAEDICSLead Orthopedic Faculty

Senior Orthopedic Surgeon demonstrating operative exposures, internervous planes, and trauma corridors.

DEPARTMENT OF ANATOMYAnatomical Lead

Guiding fascial compartment navigation, neurovascular tree mapping, and specimen preparation.

ORGANIZING COMMITTEEWet-Lab Coordinator

Coordinating dissection table setups, surgical instrument sets, and delegate station rotations.

Workshop Report: 20 PG Students Trained • Hands-On Cadaver Workshop

Conducted on 02/08/2025 | Hands-on Cadaver Workshop organized jointly by the Department of Orthopaedics and Department of Anatomy.

PG Students Trained

0 Day

Intensive Hands-on Workshop

Cadaveric Surgical Dissection

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Surgical approaches to upper limb

OVERVIEW

COURSE DETAILS

SUBJECTS COVERED

COURSE REQUIREMENTS

OVERVIEW

COURSE DETAILS

SUBJECTS COVERED

Module 1: Shoulder Girdle & Deltopectoral Approach

Module 2: Humeral Shaft Exposures (Anterior & Posterior)

Module 3: Elbow Joint Approaches (Medial, Lateral & Posterior)

Module 4: Forearm Shaft Approaches (Henry & Thompson)

Module 5: Distal Radius, Wrist & Hand Decompressions

COURSE REQUIREMENTS

Target Audience

Lab Infrastructure

WORKSHOP FACULTY & ORGANIZERS

Workshop Report: 20 PG Students Trained • Hands-On Cadaver Workshop

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