Surgical Discussion

Patient positioning:  The patient is positioned in a supine position, with the affected arm extended and supported on a hand table, ensuring optimal visualization of the surgical site.

Anatomical surgical approach:  A modified Henry approach is performed, starting with a longitudinal incision on the volar aspect of the forearm, centered over the distal radius. It is carefully dissected between the flexor carpi radialis muscles and the tendons of the flexor pollicis longus, protecting the median nerve and radial vessels. The periosteum of the radius is exposed and subperiosteal elevation is performed to visualize the fracture.

During the operation, adequate reduction of the bone fragments is achieved using Kirschner wires as temporary guidance. Given dorsal comminution, special attention is paid to restoring the volar angle and radial length. Definitive fixation is performed with a distal radius locking plate, ensuring stability and allowing prompt mobilization.

Postoperative protocol:   Early mobilization begins under physiotherapy supervision, avoiding significant loads or efforts on the operated wrist during the first 6 weeks. The importance of range of motion exercises and gradual strengthening is emphasized.

Follow up:   No especificado.

Orthopaedic implants used:   Distal radius locked plate, Kirschner wires.