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- Technique:
    - position: supine;
          - ulnar fractures: arm pronated across the chest;
          - radial fractures: arm abducted and in neutral rotation;
    - fractures of both bones of forearm are carried out through separate incisions, w/ 2-2.75 inch skin brige left between two;
    - Approach to the Ulna:
          - parallel and slightly volar to the subcutaneous crest of the ulna;
          - w/ Henry approach, make the incision more dorsally and with the Thompson approach make the incision more volarly (to maximize the skin bridge);
          - note that volarly placed incisions, may cause incisional discomfort when the patient rests the forearm on a table (not the case w/ more dorsal incisions);
    - Approach to the Radial Shaft:
          - Anterior Approach: (Henry);
                  - anterior approach is required if compartment syndrome is present;
                  - some surgeons prefer this approach for proximal 1/3 and distal 1/3 radial frx;
                           - proximally, the PIN is protected by the supinator, which facilitates future plate removal;
                  - although this defies placing plate on the tension side (dorsal radius), soft tissue coverage on volar side is better & bone contour is flat, making it easier to apply plate;
                  - if the anterior approach to the radius is utilized, then the ulnar incision should be made more dorsally;
          - Dorsal Approach (Thompson):
                  - some prefer dorsal approach for fractures of the middle third;
                  - main disadvantage is potential injury to PIN;
                  - also danger to nerve if plate is removed through dorsal approach, since scarring makes visualization of nerve is difficult, esp in proximal 1/3;
                  - note: if the dorsal approach to the radius is utilized, then the ulnar incision should be placed more volarly inorder to maximize the skin bridge

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Comparison of Dorsal and Volar Approaches to the Proximal Radius