Cranial approach to the cat distal radius

This approach is indicated for lag screw fixation of B2 fractures, and for K-wire fixation of distal radial fractures.

Retraction of tendons to expose the dorsal surface of the distal radius during the cranial approach

Key anatomical landmarks:

Lateral styloid process
Metacarpal bones

Note: It is crucial to protect the cephalic vein and the extensor carpi radialis throughout the approach.
When necessary, the abductor pollicis longus can be transected to improve exposure and plate placement.

For this approach, the patient is positioned in one of the following positions:

Sternal recumbency
Lateral recumbency (affected limb down or up)
Dorsal recumbency

Patient positioned in sternal, lateral, and dorsal recumbency

A skin incision is made on the cranial surface with the extent of the incision dictated by the procedure that is to be performed.

The incision is lateral to the accessory cephalic vein.

The deep antebrachial fascia is incised between the tendon of the extensor carpi radialis and the tendon of the common digital extensor.

Incision of the deep antebrachial fascia

The tendon of the extensor carpi radialis is retracted medially and the tendon of the common digital extensor is retracted laterally to expose the dorsal surface of the distal radius.

Retraction of tendons to expose the dorsal surface of the distal radius.

A dorsal arthrotomy may be necessary for articular fracture repair or for pancarpal arthrodesis.

$Dorsal arthrotomy for articular fracture repair or pancarpal arthrodesis$

If an arthrotomy has been performed, it should be repaired with sutures. The subcutaneous tissue and skin are closed according to the surgeon's preference.

Note: When plates are used for fracture repair, wound closure may be difficult due to excessive skin tension.