Displaced Radial Shaft Fracture: The Dorsal (Thompson) Approach to the Forearm.

Abstract

This video demonstrates a displaced radial shaft fracture repaired through a dorsal (Thompson) approach to the forearm. The patient is an 18-year-old man who sustained a left elbow dislocation and ipsilateral radial shaft fracture (OTA/AO: 22-B2) while playing basketball. The patient underwent a closed reduction of the elbow joint and was indicated for operative repair of the radius. Ultimate fixation included a compression plate and nonlocking screws through a dorsal approach to the radius. Anatomic reduction and stable fixation was obtained. The posterior interosseus nerve was identified and protected throughout the procedure. A dorsal (Thompson) approach to a radial shaft fracture is advantageous for fractures involving the proximal and middle-third of the radius. This approach can also be used when there is soft tissue damage (open wounds) on the dorsal aspect, which require debridement.