Comprehensive guide to the Henry (volar) approach to the radius - the most versatile forearm approach for distal radius fractures, radial shaft fractures, and forearm compartment syndrome - surgical anatomy, radial artery management, and exam preparation
Reviewed by OrthoVellum Editorial Team
Orthopaedic clinicians and medical editors • Published by OrthoVellum Medical Education Team
Most Versatile Forearm Approach | Extensile | Radial Artery at Risk
The leash of Henry is a series of radial artery perforators that supply the pronator quadratus and distal radius. These vessels penetrate the pronator quadratus and must be carefully ligated when elevating the muscle from the radial border. Failure to ligate causes troublesome bleeding and poor visualization.
The superficial radial nerve emerges from under brachioradialis in the distal third of the forearm and runs superficially to supply sensory innervation to the dorsal first web space. Injury causes numbness and painful neuroma formation. Protect by retracting BR radially without excessive traction.
Pronator quadratus is the key to distal radius exposure. Elevate it sharply from the radial border (not ulnar - protects anterior interosseous nerve). Always repair the PQ at closure - it provides vascular supply to distal radius and improves healing. Some studies show better outcomes with PQ repair.
True internervous plane exists only in distal two-thirds between brachioradialis (radial nerve) and flexor carpi radialis (median nerve). Proximal extension is not internervous - pronator teres (median) must be released from radius. This is why the approach is safest distally.
The Henry (volar) approach is the most versatile forearm approach, providing extensile access from radial styloid to radial tuberosity for distal radius fractures (volar plating), radial shaft fractures, and forearm fasciotomy. The internervous plane (distally) lies between brachioradialis (radial nerve) and flexor carpi radialis (median nerve)—proximally this plane does not exist as pronator teres (median) must be released. The leash of Henry (radial artery perforators to pronator quadratus) must be ligated for distal exposure. Pronator quadratus is elevated from the radial border (protecting the AIN) and should be repaired at closure. At-risk structures include the superficial radial nerve (emerges under BR distally) and radial artery. Patient positioning is supine with arm supinated on hand table.
Memory Hook:HENRY approach is named after Arnold Henry who described this extensile volar approach in 1973 - remember the key steps from superficial to deep
Memory Hook:The LEASH of Henry must be controlled to prevent bleeding and achieve good visualization of the distal radius
Memory Hook:VOLAR approach steps ensure systematic safe exposure of the distal radius for fracture fixation
The Henry approach (volar approach to the radius) is the most versatile and commonly used approach to the radius, providing exposure from the radial styloid distally to the radial tuberosity proximally. It is the gold standard approach for volar plating of distal radius fractures, which has become the predominant treatment for unstable extra-articular and intra-articular fractures.
Historical development:
Clinical significance:
Why Volar Plating Became Gold Standard
Volar plating replaced dorsal plating as the gold standard for distal radius fractures in the early 2000s due to: (1) Lower complication rates - fewer extensor tendon problems compared to dorsal plates, (2) Better biomechanics - plate on tension side resists typical dorsal angulation, (3) Fixed-angle constructs - locking screws provide better purchase in osteoporotic bone, (4) Easier approach - volar Henry approach is more straightforward than dorsal approach. Current use in Australia exceeds 80% of operatively treated distal radius fractures.
Alternative approaches to radius:
The volar forearm anatomy is organized in distinct layers from superficial to deep, with critical neurovascular structures running in predictable intervals.
Surface anatomy and landmarks:
| Layer | Structures | Innervation | Clinical Significance |
|---|---|---|---|
| Skin and subcutaneous | Lateral cutaneous nerve of forearm, cephalic vein | Musculocutaneous continuation | Preserve cephalic vein if possible |
| Superficial fascia | Brachioradialis (lateral), FCR (medial) | Radial nerve (BR), median nerve (FCR) | Internervous interval - key to approach |
| Neurovascular | Radial artery, superficial radial nerve | N/A (artery and nerve) | Radial artery between BR and FCR - protect |
| Deep flexors | FPL (radial), FDS/FDP (ulnar) | Median nerve (FPL), Median/ulnar (FDS/FDP) | Retract FPL ulnarly to expose PQ |
| Deepest muscle | Pronator quadratus | Anterior interosseous nerve | Elevate from radial border - covers radius |
Muscle layers and innervation (superficial to deep):
Brachioradialis (BR)
Flexor carpi radialis (FCR)
Pronator teres (PT)
Flexor pollicis longus (FPL)
Pronator quadratus (PQ)
Neurovascular anatomy and danger zones:
The radial artery runs throughout the forearm between brachioradialis (lateral) and flexor carpi radialis (medial). It is the key landmark for the Henry approach. Distally (distal third), the artery runs more superficially and gives off the leash of Henry - multiple small perforating branches that supply pronator quadratus and distal radius. These must be ligated. The artery can be retracted medially or laterally depending on the level of exposure - generally retract medially with FCR for distal radius exposure.
Superficial radial nerve:
Median nerve:
Anterior interosseous nerve (AIN):
| Level | Artery Position | Management | Key Branches |
|---|---|---|---|
| Proximal third | Deep to BR, between PT and BR | Retract laterally with BR or medially with PT | Recurrent radial artery (proximal) |
| Middle third | Between BR and FCR, relatively superficial | Protect - can retract either direction | Muscular branches |
| Distal third | Superficial, between BR and FCR tendons | Retract medially with FCR for radius exposure | Leash of Henry (must ligate) |
Pronator quadratus anatomy:
Relationship to radius:
Most Common Indication
The most common indication for the Henry approach is volar plating of unstable distal radius fractures. In Australian practice, over 80% of operatively treated distal radius fractures are now managed with volar locking plates via the Henry approach. This represents a major shift from dorsal plating in the 1990s to predominantly volar plating in the 2000s-2020s.
Primary indications:
Distal radius fractures (ORIF)
Radial shaft fractures
Forearm compartment syndrome
Other indications
Absolute contraindications:
Relative contraindications:
| Fracture Pattern | Preferred Approach | Rationale | Alternative |
|---|---|---|---|
| Distal radius extra-articular (AO 23-A) | Henry (volar) | Volar locking plate resists dorsal angulation | Percutaneous K-wires if minimally displaced |
| Distal radius intra-articular (AO 23-C) | Henry (volar) | Can add arthroscopy or dorsal approach for die-punch | Fragment-specific fixation may need combined approaches |
| Radial shaft middle third | Henry (volar) or Thompson (dorsal) | Henry easier, Thompson if posterior interosseous nerve palsy | Both acceptable - surgeon preference |
| Both-bone forearm fracture | Henry (radius) + separate ulnar approach | Two incisions - radius volar, ulna dorsal/subcutaneous | Single-incision technique (higher complication rate) |
The Henry approach utilizes an internervous plane in the distal two-thirds of the forearm, but this is NOT truly internervous proximally.
Distal two-thirds (TRUE internervous plane):
Proximal third (NOT truly internervous):
Clinical significance:
When extending the Henry approach proximally for radial shaft fractures, remember this is NOT a true internervous plane. The pronator teres (median nerve innervated) must be released from the radius. Tag it for repair at closure to restore pronation strength. Additionally, the superficial radial nerve emerges from under brachioradialis 7-9 cm proximal to the radial styloid and must be identified and protected to prevent sensory loss and neuroma formation.
Standard positioning for Henry approach:
Patient position:
Forearm position:
Anesthesia:
Tourniquet:
Preparation and draping:
Full forearm supination is essential for the Henry approach because it rotates the radius anteriorly, bringing the volar surface into optimal position for exposure. Inadequate supination results in a more lateral approach and difficulty accessing the volar radius. Check supination after draping and positioning. If the patient cannot achieve full supination (e.g., DRUJ arthritis, malunion), consider alternative positioning or approach.
Fluoroscopy setup:
Instruments and implants:
By Extent of Exposure:
By Intent:
Distal Radius (AO/OTA 23):
Radial Shaft (AO/OTA 22):
| Grade | Plate Position | FPL Rupture Risk | Management |
|---|---|---|---|
| Grade 0 | Proximal to watershed line (2-3mm from volar rim) | Minimal (ideal position) | No action needed - optimal |
| Grade 1 | At watershed line (on volar rim) | Low to moderate | Acceptable - monitor symptoms |
| Grade 2 | Distal to watershed line (prominent beyond volar rim) | High - all reported FPL ruptures | Consider revision or plate removal after union |
Soong Classification - FRACS Must Know
The Soong classification is the most important post-operative assessment tool for volar plate position. Grade 2 plates are at highest risk for FPL tendon rupture - all reported cases of FPL rupture occurred with Grade 2 plates. Assess plate position on true lateral radiograph by drawing a line along the volar cortex of the radius - plate should be proximal to or at this line, never beyond it.
Mechanism of injury:
Patient factors:
Inspection:
Palpation:
Document neurovascular status before any intervention:
Any deficit = urgent surgical consultation
| Assessment | Normal Finding | Abnormal - Concern | Action Required |
|---|---|---|---|
| Radial pulse | Palpable, equal to contralateral | Weak or absent | Urgent reduction, vascular surgery consult |
| Capillary refill | Less than 2 seconds all fingers | Delayed or absent | Reduce fracture, reassess, vascular consult if persistent |
| Median nerve sensation | Intact thenar eminence and radial 3.5 digits | Numbness (acute carpal tunnel) | Urgent reduction, consider carpal tunnel release |
| Compartment firmness | Soft compartments | Tense, painful with passive stretch | EMERGENCY fasciotomy |
| Skin integrity | Intact | Open wound, skin tenting | Antibiotics, tetanus, urgent surgery |
Standard views (mandatory):
Contralateral wrist if complex or uncertain anatomy
Radial inclination: 22-23 degrees (PA view)
Radial height: 11-12mm (PA view)
Volar tilt: 10-12 degrees (lateral view)
Ulnar variance: Neutral to -1mm (PA view)
Articular step: Less than 2mm acceptable
| Parameter | Normal Value | Acceptable After Reduction | Surgical Indication |
|---|---|---|---|
| Radial inclination | 22-23 degrees | Greater than 15 degrees | Less than 15 degrees = ORIF |
| Radial height | 11-12mm | Less than 5mm shortening | Greater than 5mm shortening = ORIF |
| Volar tilt | 10-12 degrees (volar) | Neutral to 10 degrees dorsal | Greater than 10 degrees dorsal = ORIF |
| Articular step-off | 0mm | Less than 2mm | Greater than 2mm = ORIF |
| Ulnar variance | Neutral to -1mm | Less than 3mm positive | Greater than 3mm positive = ORIF |
Unacceptable Alignment - Surgical Threshold
FRACS viva key thresholds for ORIF:
Remember: These are guidelines - patient factors (age, activity level, hand dominance) influence final decision.
Indications:
Method: Closed reduction and casting (6 weeks)
Indications (any one present):
| Treatment | Indication | Advantages | Disadvantages |
|---|---|---|---|
| Closed reduction + casting | Stable, minimal displacement | Non-invasive, low cost | Loss of reduction risk, stiffness |
| Volar locking plate (Henry approach) | Unstable fractures - gold standard | Stable fixation, early mobilization, low tendon complications | Hardware cost, requires surgery |
| External fixation | Severe comminution, open fractures (temporizing) | Bridge fixation, good for severe comminution | Pin site infection, stiffness, overdistraction |
| Percutaneous K-wires | Simple extra-articular fractures | Minimally invasive, low cost | Pin site infection, loss of reduction, stiffness |
| Fragment-specific fixation | Complex intra-articular fractures | Addresses specific fragments | Technically demanding, multiple implants |
Volar Locking Plate - Gold Standard
Volar locking plate fixation via Henry approach is the gold standard treatment for unstable distal radius fractures in Australia (over 80% of operatively treated fractures). Key advantages:
Incision:
Mark incision from radial styloid proximally along FCR tendon for 6-8 cm
Incise skin and subcutaneous tissue down to deep fascia
Superficial dissection:
Identify flexor carpi radialis tendon - key landmark
Open FCR tendon sheath longitudinally
Retract FCR ulnarly to expose radial artery
Managing radial artery:
Deep dissection:
Identify flexor pollicis longus (FPL) on radial side
Expose pronator quadratus - now visible on distal volar radius
Pronator quadratus elevation (critical step):
Elevate pronator quadratus from RADIAL border
Reflect PQ ulnarly to expose entire distal radius volar surface
Fracture reduction and fixation:
Reduce fracture under direct vision
Provisional fixation with K-wires
Apply volar locking plate
Confirm reduction and fixation
Closure:
Repair pronator quadratus (important step - often overlooked)
Close FCR sheath (optional - some surgeons leave open)
Close subcutaneous tissue and skin
Apply sterile dressing and splint
The distal radius approach is now complete with excellent fracture reduction and stable fixation.
Complications can be categorized as intraoperative, early postoperative, and late.
| Complication | Incidence | Prevention | Management |
|---|---|---|---|
| Radial artery injury | 1-2% (iatrogenic transection or laceration) | Identify artery early, retract gently, ligate leash of Henry carefully | Primary repair if transected, pressure if lacerated, check hand perfusion |
| Superficial radial nerve injury | 5-10% (traction neuropraxia or laceration) | Avoid excessive BR retraction, identify nerve in proximal dissection | Neuropraxia resolves 3-6 months, laceration requires nerve repair/graft |
| Median nerve injury | Less than 1% (rare - usually traction) | Avoid FCR over-retraction, protect median nerve deep to FCR | Usually neuropraxia - observe, rarely needs exploration |
| Flexor tendon injury (FPL, FDS) | Less than 1% (intraoperative laceration) | Identify tendons, retract gently, avoid sharp dissection near tendons | Primary tendon repair if recognized, may need staged reconstruction if missed |
| Infection (superficial or deep) | 1-3% (higher in open fractures) | Perioperative antibiotics, sterile technique, wound care | Antibiotics for superficial, may need washout and hardware removal for deep |
| Flexor tendon irritation (FPL) | 5-15% (plate prominence or screw length) | Position plate 2-3mm proximal to volar rim, check screw lengths, repair PQ | Plate removal if symptomatic, usually after fracture union (6-12 months) |
Specific complications:
Radial artery injury:
Superficial radial nerve injury:
Flexor pollicis longus (FPL) tendon irritation:
FPL tendon rupture is a devastating complication of volar plating reported in up to 1-2% of cases. The mechanism is attrition wear of the FPL tendon over a prominent volar plate or screw. Risk factors: (1) Plate extending beyond volar rim, (2) Dorsal screw penetration with volar prominence, (3) Failure to repair pronator quadratus. Prevention is key. If rupture occurs, treatment options include FPL tendon graft reconstruction or fusion of thumb IP joint. Warn patients to report triggering or thumb weakness immediately.
Median nerve injury:
Anterior interosseous nerve (AIN) palsy:
Loss of reduction / fixation failure:
Complex regional pain syndrome (CRPS):
Immediate postoperative management (0-2 weeks):
Day of surgery:
First 48 hours:
Week 1-2:
Intermediate rehabilitation (2-6 weeks):
Weeks 2-6:
Clinical assessment:
Late rehabilitation (6 weeks to 6 months):
6 weeks onward:
3 months:
6-12 months:
| Timepoint | Expected Progress | Restrictions | Red Flags |
|---|---|---|---|
| 2 weeks | Wound healed, minimal pain, fingers mobile | Splint on, no lifting | Wound infection, increasing pain, finger stiffness |
| 6 weeks | 50% wrist ROM, 40% grip strength, fracture healing on X-ray | Light activities only, no heavy lifting | Loss of reduction, worsening pain, CRPS symptoms |
| 12 weeks | 75-80% wrist ROM, 70% grip strength, fracture healed | Return to most activities, progress strengthening | Persistent severe stiffness, FPL triggering, nerve symptoms |
| 6-12 months | Near-normal ROM and strength, full function | None - full activities allowed | Persistent symptoms may need hardware removal or further intervention |
Australian context - PBS:
Pharmaceutical Benefits Scheme (PBS):
Expected outcomes:
Range of motion recovery:
Grip strength: 75-90% of contralateral by 12 months
DASH score improvement:
Patient satisfaction: 85-95% satisfied/very satisfied
| Timepoint | ROM Recovery | Grip Strength | Pain (VAS) | Return to Function |
|---|---|---|---|---|
| 6 weeks | 50% of contralateral | 30-40% of contralateral | 2-4/10 | Light ADLs, desk work |
| 3 months | 70-80% of contralateral | 60-70% of contralateral | 1-2/10 | Most ADLs, light work |
| 6 months | 80-90% of contralateral | 80-85% of contralateral | 0-1/10 | All activities except heavy loading |
| 12 months | 85-95% of contralateral | 85-95% of contralateral | 0/10 | Full function, return to sport |
Good to Excellent Outcomes
80-90% of patients treated with volar locking plate fixation via the Henry approach achieve good to excellent outcomes at 12 months. Key predictors of outcome:
Question 1: Internervous Plane
Q: What is the internervous plane in the distal Henry approach to the radius?
A: Between brachioradialis (radial nerve) and flexor carpi radialis (median nerve) in the distal two-thirds only. The approach is NOT truly internervous proximally, as pronator teres (median nerve) must be released to expose the proximal radius.
Question 2: Leash of Henry
Q: What structure must be ligated when elevating pronator quadratus in the Henry approach?
A: The leash of Henry - a series of radial artery perforators that supply the pronator quadratus and distal radius. These vessels penetrate the muscle and must be carefully ligated to prevent persistent bleeding during exposure.
Question 3: Pronator Quadratus Elevation
Q: From which border should pronator quadratus be elevated during the Henry approach, and why?
A: From the RADIAL border (not ulnar). This protects the anterior interosseous nerve, which runs on the ulnar side of the pronator quadratus. Elevating from the ulnar border risks direct injury to the AIN.
Question 4: FPL Tendon Rupture Prevention
Q: How do you prevent flexor pollicis longus (FPL) tendon rupture after volar plating of the distal radius?
A: Position the plate 2-3mm proximal to the volar rim of the radius (Soong grade 0), ensure no dorsal screw penetration with volar prominence, check screw lengths carefully, and repair the pronator quadratus at closure to provide a soft tissue cushion over the plate.
Question 5: Superficial Radial Nerve
Q: Where does the superficial radial nerve emerge in relation to the Henry approach, and what is at risk if it is injured?
A: The superficial radial nerve emerges from under brachioradialis approximately 7-9 cm proximal to the radial styloid in the distal third of the forearm. Injury causes numbness in the dorsal first web space and painful neuroma formation. Prevent by avoiding excessive traction on BR.
Question 6: Proximal Extension
Q: What additional structure must be released when extending the Henry approach proximally for radial shaft fractures?
A: Pronator teres must be released from its insertion on the middle third of the radius. This is necessary for proximal radius exposure but means the approach is NOT truly internervous proximally (PT is innervated by median nerve). Tag PT for repair at closure.
Question 7: Forearm Position
Q: Why is full forearm supination critical for the Henry approach?
A: Full supination rotates the radius anteriorly, bringing the volar surface into optimal position for direct exposure. It also moves the posterior interosseous nerve away from the surgical field when working near the supinator muscle proximally. Inadequate supination makes volar access difficult.
Question 8: Radial Artery Management
Q: How should the radial artery be managed during the distal Henry approach?
A: The radial artery runs in the interval between BR and FCR. For distal radius exposure, retract it medially with the FCR. The artery can be ligated if accidentally injured, provided the Allen test confirms adequate ulnar artery perfusion (dual blood supply to hand).
Question 9: Volar vs Dorsal Plating
Q: Why has volar locking plate fixation replaced dorsal plating as the gold standard for distal radius fractures?
A: Volar plating has: (1) Lower complication rates - fewer extensor tendon problems, (2) Better biomechanics - plate on tension side resists typical dorsal angulation, (3) Fixed-angle constructs - locking screws provide superior purchase in osteoporotic bone, (4) Easier surgical approach - Henry approach is more straightforward than dorsal Thompson approach.
Question 10: Pronator Quadratus Repair
Q: What is the evidence for repairing pronator quadratus after volar plating?
A: Level II evidence shows PQ repair improves outcomes: better wrist flexion (65° vs 55°), improved pronation (75° vs 68°), and higher grip strength (78% vs 70% of contralateral). PQ also provides a soft tissue cushion over the plate, reducing FPL irritation risk.
Question 11: Soong Classification
Q: What is the Soong classification and its clinical significance?
A: The Soong classification assesses volar plate position:
Plates should be positioned Grade 0 (2-3mm proximal to volar rim) to prevent tendon attrition.
Question 12: AIN Function Testing
Q: How do you test for anterior interosseous nerve (AIN) injury after the Henry approach?
A: Test the "OK sign": Ask patient to make a circle with thumb and index finger. AIN innervates FPL (thumb IP flexion), FDP to index/long fingers (DIP flexion), and pronator quadratus. Injury prevents IP/DIP flexion - unable to make tight "OK" sign. No sensory loss (AIN is pure motor).
Question 13: Compartment Syndrome
Q: When performing forearm fasciotomy via the Henry approach for compartment syndrome, what is the key management principle?
A: Do NOT close the skin - leave wound open, apply sterile dressing, and plan return to OR in 24-48 hours for second look. Assess muscle viability by the 4 Cs: Color (pink viable), Contractility (contracts with stimulation), Consistency (firm and elastic), Capillary bleeding. Debride nonviable muscle.
Question 14: Most Common Indication
Q: What is the most common indication for the Henry approach in Australia?
A: Volar locking plate fixation of unstable distal radius fractures - accounts for over 80% of operatively treated distal radius fractures in Australian practice. This represents a major shift from dorsal plating dominant in the 1990s to predominantly volar plating in 2000s-2020s.
Question 15: Common Exam Trap
Q: A candidate states "The Henry approach is an internervous plane throughout the forearm." Is this correct?
A: NO - this is a common exam trap! The approach is internervous only in the distal two-thirds (BR radial nerve, FCR median nerve). In the proximal third, pronator teres (median nerve) must be released from the radius, making it NOT a true internervous approach. Always qualify your answer with "distally" when discussing the internervous plane to avoid this trap.
Epidemiology in Australia:
Distal radius fractures are extremely common in Australia, with approximately 40,000 cases per year. They represent the most common fracture requiring surgical fixation in adults over 50 years of age. The incidence is steadily increasing with the aging population, and there is a strong female predominance (4:1 ratio) due to postmenopausal osteoporosis.
Treatment trends in Australia:
Volar locking plate fixation via the Henry approach has become the gold standard treatment, now accounting for over 80% of operatively treated distal radius fractures in Australia. This represents a dramatic shift from dorsal plating and external fixation techniques that were dominant in the 1990s. The transition to volar plating occurred primarily between 2000-2010, driven by evidence of lower complication rates and improved patient satisfaction.
Funding and reimbursement:
Distal radius ORIF is covered under Medicare with similar coverage for radial shaft fractures. Volar locking plate systems cost between AUD 1,500-3,000 and are funded through the Prostheses List for public hospitals or private health insurance for private patients. WorkCover covers work-related injuries in all states, with return to work being a key outcome metric.
Australian clinical guidelines:
The eTG (Therapeutic Guidelines) recommend cephazolin 2g IV as perioperative antibiotic prophylaxis for distal radius ORIF, with a single dose adequate for procedures under 4 hours. Vancomycin is recommended for patients with penicillin allergy. For established infections, flucloxacillin is first-line for methicillin-sensitive organisms, with increasing use of vancomycin for MRSA given rising prevalence in Australian hospitals.
Rehabilitation and return to work:
Return to work timelines vary by occupation: sedentary workers typically return at 2-4 weeks, light manual workers at 6-8 weeks, and heavy manual workers at 12 weeks or longer. WorkCover cases prioritize early mobilization and functional restoration to facilitate timely return to employment.
Outcomes data:
Australian registry data and published studies demonstrate good to excellent outcomes in 80-90% of patients treated with volar locking plates. Complication rates are consistent with international literature, and hardware removal for symptomatic plates is required in 10-15% of cases, typically after fracture union at 6-12 months.
Practice these scenarios to excel in your viva examination
"Post-operative X-rays show your volar plate positioned at the volar rim. The patient is 6 weeks post-op and complaining of triggering of the thumb. How do you classify the plate position and manage this?"
"A 55-year-old woman presents with a displaced distal radius fracture after a fall. She has numbness in her thumb, index, and long fingers. The fracture is grossly displaced with volar angulation. How do you assess and manage the median nerve symptoms?"
"You are shown an X-ray of a comminuted intra-articular distal radius fracture in a 45-year-old carpenter. The PA X-ray shows articular involvement but it is difficult to assess the exact fracture pattern. Would you order a CT scan?"
"A 68-year-old woman with osteoporosis presents with a distal radius fracture. After closed reduction, X-rays show 15 degrees dorsal tilt, 5mm radial height loss, and 2mm articular step-off. She is right-hand dominant (injured side) and works part-time as a receptionist. How do you manage this?"
"A 50-year-old right-hand dominant accountant is 2 days post volar plating of a distal radius fracture. She asks you what outcomes she can expect and when she can return to work."
High-Yield Exam Summary
Henry AK. Extensile Exposure. 2nd ed. Edinburgh: Churchill Livingstone; 1973.
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Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. J Hand Surg Am. 2008;33(6):809-19. doi:10.1016/j.jhsa.2008.02.016
Klug RA, Press CM, Gonzalez MH. Rupture of the flexor pollicis longus tendon after volar fixed-angle plating of a distal radius fracture: a case report. J Hand Surg Am. 2007;32(7):984-8. doi:10.1016/j.jhsa.2007.05.016
Bentohami A, Bosma J, Akkersdijk GJ, van Dijkman B, Goslings JC, Schep NW. Incidence and characteristics of neurovascular injuries in open distal radius fractures. Eur J Trauma Emerg Surg. 2014;40(3):321-6. doi:10.1007/s00068-013-0350-8
Australian Orthopaedic Association National Joint Replacement Registry. Hip, Knee & Shoulder Arthroplasty: 2023 Annual Report. Adelaide: AOA; 2023.
Therapeutic Guidelines Ltd. Antibiotic. Version 16. Melbourne: Therapeutic Guidelines Ltd; 2024. Available from: https://www.tg.org.au
Australian Government Department of Health and Aged Care. Orthopaedic procedure guidelines. Updated 2024.
Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. J Am Acad Orthop Surg. 2005;13(3):159-71. doi:10.5435/00124635-200505000-00003
Lutsky K, Beredjiklian PK. Functional outcomes after volar plating of distal radius fractures. J Hand Surg Am. 2015;40(9):1854-9. doi:10.1016/j.jhsa.2015.03.006
Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop. 2003;27(1):1-6. doi:10.1007/s00264-002-0393-x