VOLAR APPROACH TO THE DISTAL RADIUS :
Fractures of the distal radius are common injuries. They constitute of about one-sixth of all the fractures. (1, 2) Accurate understanding of the neurovascular anatomy of the volar aspect of the distal radius is therefore fundamental in avoiding iatrogenic injury during the surgical approach. (3)The two most common approaches to the distal radius are the classic Henry approach between the flexor carpi radialis (FCR) tendon and the radial artery, and the modified Henry approach through the sheath of the FCR tendon. Both approaches use an 8–10 cm skin incision directly over the FCR tendon differing only in the superficial interval utilized to expose the deep volar compartment. (4) Complications from volar plating of distal radius fractures vary from 3 to 27% which includes neurovascular injury. (5, 6, 7, 8)

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References:
1. Golden GN. Treatment and prognosis of Colles’ fracture.
Lancet. 1963;1(7280):511–5.
2. Owen RA, Melton LJ, Johnson KA, Ilstrup DM, Riggs BL. Incidence of Colles’ fracture in a North American community. Am J Public Health. 1982;72(6):605–7.
3. McCann P.A., Clark D., Amirfeyz R., Bhatia R. The cadaveric anatomy of the distal radius: implications for the use of volar plates. Ann R Coll Surg Engl. 2012;94:116–120.
4. Ilyas A.M., Ilyas A.M. Surgical approaches to the distal radius. Hand. 2011;6:8–17.
5. Arora R., Lutz M., Hennerbichler A., Krappinger D., Espen D., Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21:316–322.
6. Drobetz H., Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop. 2003;27:1–6.
7. Kamano M., Koshimune M., Toyama M., Kazuki K. Palmar plating system for Colles’ fractures—a preliminary report. J Hand Surg Am. 2005;30:750–755.
8. Rozental T.D., Blazar P.E. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006;31:359–365.

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