Extensile posterior approach to the radius.

Abstract

An extensile posterior approach to the radius was studied on 20 forearm anatomic specimen upper limbs. The skin incision followed a line from the lateral epicondyle of the humerus to a point corresponding to the middle of the posterior aspect of the wrist. Dissection was done between the extensor digitorum communis and the extensor carpi radialis brevis. The posterior interosseous nerve was identified, and the muscle fibers of the superficial head of the supinator were divided from distal to proximal to the posterior interosseous nerve, which was dissected and carefully retracted laterally. The muscle fibers of the deep head of the supinator were divided to the bone. An incision was made along the superior and inferior margins of the abductor pollicis longus and extensor pollicis brevis. A nerve tape was placed around the two muscles, and they were retracted proximally and medially or distally and laterally, as necessary. To expose the distal third of the radius, the obliquely placed muscles, abductor pollicis longus, and extensor pollicis brevis were retracted proximally and medially. Dissection was done between the extensor carpi radialis brevis and extensor pollicis longus. Anatomic study of the posterior interosseous nerve branches was done to understand the vulnerability of such branches seen in this approach.