Volar-Ulnar Approach for Fixation of the Volar Lunate Facet Fragment in Distal Radius Fractures: A Technical Tip

Abstract

The volar Henry approach is most commonly used for surgical fixation of distal radius fractures. However, this approach is limited in achieving adequate exposure for the fixation of the volar-ulnar portion of the distal radius, rendering it difficult for the ideal placement of the fixation construct. We propose the use of the extensile volar-ulnar approach for fixation of distal radius fracture involving a small volar-ulnar fragment. This approach allows optimal reduction of the sigmoid notch and the volar lunate facet, which anatomically reduces both the radiocarpal joint and the sigmoid notch. In addition, extension of this approach may safely be performed if concomitant carpal tunnel release is necessary.

Keywords: Articular fracture; distal radius; locked plating; volar lunate facet; volar-ulnar distal radius approach.