The COLD approach, described by Lewicky, Sheppard, and Ruth, with the patient in the lateral decubitus position (right arm depicted). The olecranon osteotomy component is reflected proximally while dissection proceeds along the lateral intermuscular septum. The radial nerve is seen obliquely crossing the humerus distal to the deltoid insertion split. (Modified from Lewicky YM, Sheppard JE, Ruth JT: The combined olecranon osteotomy, lateral para tricipital sparing, deltoid insertion splitting approach for concomitant distal intra-articular and humeral shaft fractures, J Orthop Trauma 21:135, 2007.) SEE TECHNIQUE 1.106.