- See:
-
Anterior Approach to the Radial Shaft: (Henry)
-
Blount Fracture: Both Bone Forearm Fracture:
-
Boyd Surgical Approach:
-
Distal 1/3 of the Radius thru an Anterolateral Incision;
-
Dorsal Approach (Thompson) :
-
Galeazzi's Fracture
-
Proximal 1/3 of the Radius thru the Anterolateral Incision
- Approach to the Radius:
- when the fracture is in
distal half of the bone, expose it thru
anterior approach of Henry & apply plate to volar surface;
- this defies the principle of applying plate to tension side (dorsal surface);
- since the soft tissue coverage on the volar surface is better and
bone contour is flat, it is easier to apply plate on volar surface;
- when frx is in
proximal half, expose it thru dorsal
Thompson
approach, and apply the plate to the dorsal surface;
- radial nerve is less likely to be injured thru this approach than
thru the anterior approach;
- plate on the dorsal aspect of the proximal radius is also less
likely to produce mechanical block to pronation than if
applied to the anterior surface;
- when frx is in the
middle third either approach may be used;
- consider applying the plate to side (anterior vs. posterior) which
has greater comminution;
-
Complications: Cadaveric studies (Mathews, 1982)
- residual angulation of 10 deg in mid shaft radial frxs or ulna
or both will not limit forearm rotation anatomically
- loss of rotation is expected w/ residual angles of > 20 deg;
- degree of rotatory deformity parallels loss of pronation & supination;
- supination losses for mid 1/3 > than for distal 1/3 deformities
- compartment syndrome;
- synostosis:
- uncommon but more common in crush injuries;
---------------------------------------------------
Growth plate activity in the upper extremity.
Congenital proximal radio-ulnar synostosis. Natural history and
functional assessment.
Late results of excision of the radial head for an isolated closed
fracture.
Results of delayed excision of the radial head after fracture.
Intra-articular fractures of the distal end of the radius in young adults.
Angulated radial neck fractures in children. A prospective study of
percutaneous reduction.
