Authors of section

Authors

Anton Fürst, Wayne McIlwraith, Dean Richardson

Executive Editor

Jörg Auer

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Dorsolateral approach for medial condylar fractures

1. Introduction

This approach is generally suitable for medial incomplete as well as medial spiral condylar fracture. The exposure may vary upon fracture configuration.

Dorsolateral approach for medial condylar fractures

2. Incision

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.

Dorsolateral approach for medial condylar fractures

3. Exposure

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.

Dorsolateral approach for medial condylar fractures

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.

dorsolateral approach for medial condylar fractures

Sterile dressings are applied over the incision and covered with a padded bandage.

dorsolateral approach for medial condylar fractures