Abstract

Articular comminuted distal radius fractures are still a surgical challenge. The development of volar locking plate device allows a stable and anatomic restoration of the distal radius. We propose a modification of the classic anterior approach for articular fracture of the distal radius with ulnar impaction. By a single incision, we realize 2 windows to expose the medial and lateral column of the distal radius. This technique is indicated for complex articular distal radius fractures associated with an ulnar comminution. The dissection is extended superficially to the ulnar side of the carpal tunnel elements by a blunt dissection of the anterior part of the wrist between the skin and the superficial layer of the flexor carpi radialis, in subcutaneous tissues and the antebrachial fascia to preserve the sensitive branch of the median nerve. This new approach allows reduction of each fragment of a comminutive articular fracture without exposing the flexor tendon and median nerve to excessive tension. In our surgical armatorium, we reserved this technique for distal radius fractures with articular ulnar damage because of the possible risk to the median cutaneus branch.

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Publisher Full Text

Authors

Mares O, Graves MA, Bosch C, Chammas M, Lazerges C

Institution

Department of Hand and Upper Extremity and Nerve Repair, Montpellier Medical University UM1, Rue école de de médecine, Montpellier, France. ololmares@gmail.com

Source

Techniques in hand & upper extremity surgery 16:1 2012 Mar pg 37-41

MeSH

Bone Plates
Fractures, Comminuted
Humans
Radius Fractures
Volar Plate

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22411117