In general, there are two palmar surgical approaches to the distal radius – a modified Henry approach to the radius and a more ulnar approach, designed to expose the median nerve as well as the distal radius.
modified Henry approach is suitable for most fractures of the distal radius.
If it is desired to decompress the carpal tunnel, this may be performed either through one ulnar extensile approach or two separate approaches.
An ulnar palmar approach facilitates exposure of the sigmoid notch, the lunate facet, the palmar wrist capsule, the distal radioulnar joint and distal ulna. It is less suitable for the radial part of the distal radius.
For high energy fractures an extended ulnar approach may be used.