Executive Editor: Steve Krikler

Authors: Renato Fricker, Jesse Jupiter, Matej Kastelec

Distal forearm Partial articular fracture of the radius, with dorsal dislocation - Joint-spanning external fixation

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Anatomy of the distal forearm

A thorough knowledge of the anatomy around the wrist is essential. The following images give a short introduction.


Soft tissue anatomy - dorsal

Extensor compartments:

  I.    Abductor pollicis longus and extensor pollicis brevis 
  II.   Extensor carpi radialis longus and brevis 
  III.  Extensor pollicis longus 
  IV. Extensor digitorum communis and extensor indicis proprius 
  V.  Extensor digiti minimi 
  VI. Extensor carpi ulnaris


  1. Superficial radial nerve
  2. Dorsal branch of ulnar nerve


Soft tissue anatomy - palmar

  1. Radial artery
  2. Flexor carpi radialis tendon
  3. Median nerve
  4. Motor branch of the median nerve
  5. Pronator quadratus muscle
  6. Flexor digitorum profundus tendons
  7. Flexor digitorum superficialis tendons
  8. Palmar cutaneous branch of the median nerve


Bony anatomy

  1. Lister's tubercle
  2. Sigmoid notch
  3. Ulnar head
  4. Ulnar styloid
  5. Radial styloid
  6. Scaphoid facet
  7. Lunate facet
  8. Watershed line


Principle of columns

The distal forearm may be thought of in terms of three columns. The ulna forms one column. The radius may be thought of as an intermediate and a radial column.

Distally at the wrist joint, the radial column articulates with the scaphoid and the intermediate column articulates with the lunate.

The ulnar column terminates distally at the TFCC.


Watershed line

The watershed line represents the margin between the structures which may be elevated proximally and the capsule of the wrist joint which should be respected.