Ortho-Preferred

Approach to Distal 1/3 of Radius through an Anterolateral Incision


- See:
    - Plating Techniques

- Technique:
    - incision begins in front of radial styloid process, extending proximally in straight line along anteromedial border of the brachioradialis;
    - brachioradialis is reflected laterally to expose superficial radial nerve in proximal portion;
           - avoid injury this nerve as it passes into the subcutaneus tissue;
    - radial artery is seen beneath BR deep to radial nerve;
    - FCR muscle is retracted medially;
    - radial artery & vein are retracted medially w/ FCR;
    - FDS, FPL, pronator quadratus are then exposed at bottom of wound;
    - change position of arm from supination to pronation in order to expose the portion of radius that is just lateral to pronator quadratus & FPL;
           - there is a line of insertion of these muscles that is identified on lateral aspect of the radius;
    - longitudinal incision is then made in the periosteum of radius along insertion of pronator quadratus and FPL muscles medially;
    - tendon of ECRL is seen dorso-lateral  to origins of FPL & pronator quadratus;
    - when closing the wound do not to put undue pressure on superficial branch of radial nerve or to put excessive pressure on radial artery when suturing fascia, particularly when there is extensive swelling



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, December 11, 2012 1:51 pm