Authors of section


Renato Fricker, Jesse Jupiter, Matej Kastelec

Special Authors

Dankward Höntzsch

Executive Editors

Steve Krikler, Chris Colton

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Supine (dorsal approach)

1. Supine positioning for dorsal approaches

Position the patient supine and place the forearm on a hand table.

By abducting the shoulder it is possible for the surgeon and the assistant to sit on either side of the hand table.

In order to expose the extensor aspect of the forearm, the elbow should be slightly flexed and the arm internally rotated at the shoulder.

The position of the limb should allow complete imaging in the frontal and sagittal plane of the distal radius.

A nonsterile pneumatic tourniquet is used.
Prophylactic antibiotics are optional according to local microbiological protocols.

The hand may be supported by a rolled towel.

joint spanning external fixation temporary or definitive


If shoulder rotation is limited, beware of hyperpronating the forearm as this could result in malalignment between the distal fragment and the shaft.

supine dorsal approach
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