Anatomic Considerations when Performing the Modified Henry Approach for Exposure of Distal Radius Fractures

Overview

Journal J Orthop

Specialty Orthopedics

Date 2016 Nov 12

PMID 27833358

Citations 9

Authors

Megan A Conti Mica

Randy Bindra

Steven L Moran

Affiliations

Soon will be listed here.

Abstract

Background: Identify the proximity of anatomic structures during the modified Henry approach (MHA).

Methods: Distances between median nerve (MN), palmar cutaneous branch (PCB), radial artery (RA) and the flexor carpi radialis (FCR) were measured at the wrist crease (WC), 5 and 10 cm proximal in 16 fresh frozen cadavers. The FPL origin and innervation was measured.

Results: Most at risk was the MN proximally and the PCB distally while the RA was safe. Innervation occurred at the proximal third of the FPL's origin along the ulnar aspect.

Conclusion: The MHA is safe when understanding the proximity of structures.

Citing Articles

Relative Increase in Distal Radius Exposure with Extension of the FCR Approach.

Mullikin I, Dela Cruz J, Srinivasan R, Mithani S, Novicoff W, Chhabra A Arch Bone Jt Surg. 2023; 11(11):690-695.

PMID: 38058971 PMC: 10697194. DOI: 10.22038/ABJS.2023.71179.3326.

Three Column Fixation Through a Single Incision in Distal Radius Fractures.

Kotsalis G, Kotsarinis G, Ladogianni M, Fandridis E J Wrist Surg. 2023; 12(3):232-238.

PMID: 37223379 PMC: 10202585. DOI: 10.1055/s-0042-1749162.

The prevalence and distribution of the flexor carpi radialis brevis muscle in the Turkish population.

Akkoc R, Aksu F, Emre E, Ogeturk M Sci Rep. 2022; 12(1):416.

PMID: 35013516 PMC: 8748762. DOI: 10.1038/s41598-021-04445-8.

Absence of Flexor Carpi Radialis Identified During Volar Approach for Fixation of Distal Radius Fracture: A Case Report.

Patel D, Vohra R, Singh A J Orthop Case Rep. 2021; 11(3):42-44.

PMID: 34239826 PMC: 8241248. DOI: 10.13107/jocr.2021.v11.i03.2080.

Clinical, functional and radiological outcomes of the use of fixed angle volar locking plates in corrective distal radius osteotomy for fracture malunion.

Pace V, Sessa P, Guzzini M, Spoliti M, Alessandro Carcangiu , Criseo N Acta Biomed. 2021; 92(3):e2021180.

PMID: 34212911 PMC: 8343722. DOI: 10.23750/abm.v92i3.11265.

References

Drobetz H, Kutscha-Lissberg E . Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop. 2003; 27(1):1-6. PMC: 3673689. DOI: 10.1007/s00264-002-0393-x. View

Chaynes P, Becue J, Vaysse P, Laude M . Relationships of the palmar cutaneous branch of the median nerve: a morphometric study. Surg Radiol Anat. 2004; 26(4):275-80. DOI: 10.1007/s00276-004-0226-2. View

Kamano M, Koshimune M, Toyama M, Kazuki K . Palmar plating system for Colles' fractures--a preliminary report. J Hand Surg Am. 2005; 30(4):750-5. DOI: 10.1016/j.jhsa.2005.02.009. View

Rozental T, Blazar P . Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006; 31(3):359-65. DOI: 10.1016/j.jhsa.2005.10.010. View

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(5):316-22. DOI: 10.1097/BOT.0b013e318059b993. View

Koval K, Harrast J, Anglen J, Weinstein J . Fractures of the distal part of the radius. The evolution of practice over time. Where's the evidence?. J Bone Joint Surg Am. 2008; 90(9):1855-61. DOI: 10.2106/JBJS.G.01569. View

Berglund L, Messer T . Complications of volar plate fixation for managing distal radius fractures. J Am Acad Orthop Surg. 2009; 17(6):369-77. DOI: 10.5435/00124635-200906000-00005. View

McCann P, Amirfeyz R, Wakeley C, Bhatia R . The volar anatomy of the distal radius--an MRI study of the FCR approach. Injury. 2010; 41(10):1012-4. DOI: 10.1016/j.injury.2010.02.031. View

Davis D, Baratz M . Soft tissue complications of distal radius fractures. Hand Clin. 2010; 26(2):229-35. DOI: 10.1016/j.hcl.2009.11.002. View

10.

Dolderer J, Prandl E, Kehrer A, Beham A, Schaller H, Briggs C . Solitary paralysis of the flexor pollicis longus muscle after minimally invasive elbow procedures: anatomical and clinical study of the anterior interosseous nerve. Plast Reconstr Surg. 2011; 127(3):1229-1236. DOI: 10.1097/PRS.0b013e3182043ac0. View

11.

Ilyas A . Surgical approaches to the distal radius. Hand (N Y). 2012; 6(1):8-17. PMC: 3041890. DOI: 10.1007/s11552-010-9281-9. View

12.

McCann P, Clarke 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(2):116-20. PMC: 3954133. DOI: 10.1308/003588412X13171221501186. View

13.

Chilelli B, Patel R, Kalainov D, Peng J, Zhang L . Flexor pollicis longus dysfunction after volar plate fixation of distal radius fractures. J Hand Surg Am. 2013; 38(9):1691-7. DOI: 10.1016/j.jhsa.2013.06.005. View

14.

Colles A . On the Fracture of the Carpal Extremity of the Radius. Edinb Med Surg J. 2018; 10(38):182-186. PMC: 5743240. View

15.

Matloub H, Yan J, Mink van der Molen A, Zhang L, Sanger J . The detailed anatomy of the palmar cutaneous nerves and its clinical implications. J Hand Surg Br. 1998; 23(3):373-9. DOI: 10.1016/s0266-7681(98)80061-2. View