This approach is generally suitable for medial incomplete as well as medial spiral condylar fracture. The exposure may vary upon fracture configuration.
An incision is made over the dorsolateral third metacarpal/metatarsal bone from a few cm distal to the carpometacarpal/tarsometatarsal joint down to two cm proximal to the proximal screw. The incision splits the lateral digital extensor- and the common/long digital extensor tendon as well as the periosteum to expose the dorsal surface of the bone.
Deep dissection and exposure depends on the fracture line and the chosen treatment. While for medial incomplete fractures the dorsal fracture line is exposed with a periosteal elevator just enough to follow its proximal extent, further exposure may be necessary for fixation of medial spiral fractures (as shown). Details are described in the respective procedure.
4. Wound closure
The tendon edges are apposed with synthetic, absorbable sutures. The remainder of the incision is closed routinely according to the surgeons preference.
Sterile dressings are applied over the incision and covered with a padded bandage.