Executive Editor: Steve Krikler

Authors: Renato Fricker, Jesse Jupiter, Matej Kastelec

Distal forearm

Overview

Anatomy of the distal forearm i

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

Direct to the radial styloid i

Dorsal approaches (as illustrated A-D) can be chosen between the different extensor compartments (as illustrated I-VI), as dictated by the specific fracture pattern.

Here an approach between the first and second extensor compartments (A) is described in detail.

Ulnar palmar i

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.

Dorsal approach i

Dorsal approaches (as illustrated A-D) can be chosen between the different extensor compartments (as illustrated I-VI), as dictated by the specific fracture pattern. In this module the dorsal approach through the third extensor compartment (B) is described in detail.

Palmar approach i

The modified Henry approach uses the plane between flexor carpi radialis tendon and the radial artery.

Ulnar approach i

The ulnar shaft and the fracture gap between the ulnar styloid and the distal metaphysis are usually easily palpated.

A straight, longitudinal incision is made over the distal ulna, between the tendons of the extensor and flexor carpi ulnaris.

Dorsal approach i

This extended dorsal approach can be used for wrist fusions or for joint-spanning plate fixation of comminuted intra-articular distal radius fractures.

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