A, Operating room setup with patient prone on chest rolls. For added mobility, shoulder and proximal arm are elevated on sandbag. Tourniquet is placed on proximal arm. All equipment is mounted on portable rolling platform. B, Proximal medial portal is located 2 cm proximal to medial humeral epicondyle, just anterior to medial intermuscular septum. C, Cross-sectional view of proximal medial portal. Sheath and blunt trocar are inserted anterior to intermuscular septum and in contact with anterior humerus, directed toward radial head, avoiding injury to neurovascular structures. D, Proximal medial portal provides full view of anterior joint. Gravity protects median nerve and brachial artery.