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Comparison of dorsal and volar approaches to the proximal radius.

机译:背侧和掌侧入路到近端radius骨的比较。

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Proximal radius exposure may be acquired by either the dorsal or volar approach depending on surgical requirements. The dorsal approach is traditionally recommended for fracture fixation of the proximal radius because of theoretically improved exposure and because the dorsal aspect of the bone is the tensile surface. The posterior interosseous nerve can be visualized and protected using this approach. The volar approach is preferred for biceps repair and boasts a distal extensile approach with adequate soft tissue coverage. Impingement on the bicipital tuberosity and biceps tendon, in addition to positioning on the compression side of the bone, makes the anterior or anterolateral position for plate placement less desirable. The goal of this study was to quantify and compare in a cadaver model the area of bone exposed using both approaches. We hypothesized that equivalent exposures can be obtained and the posterior interosseous nerve can be identified with either the Thompson or Henry approach. Standard dorsal and volar approaches were performed on 10 fresh-frozen adult cadaveric upper-limb specimens. Cross-sectional area of exposure was quantified from digital photographs using software. The 2 approaches did not result in a significant difference in area exposed. Depending on case requirements, either the dorsal or volar approach will provide adequate exposure to the proximal radius.
机译:取决于手术要求,可以通过背侧或掌侧方法获得近端radius骨暴露。传统上建议将背侧入路用于近端radius骨的骨折固定,因为理论上可以改善暴露程度,并且因为骨骼的背侧是拉伸表面。使用此方法可以看到并保护后骨间神经。掌侧入路是二头肌修复的首选,并拥有可充分覆盖软组织的远端伸张入路。除了定位在骨的受压侧之外,撞击在二头肌粗隆和二头肌肌腱上,还使得板放置的前部或前外侧位置不太理想。这项研究的目的是在尸体模型中量化和比较使用两种方法暴露的骨骼面积。我们假设可以使用Thompson或Henry方法获得等效的暴露量,并且可以识别后骨间神经。对10具新鲜冷冻的成人尸体上肢标本进行了标准的背侧和掌侧入路。使用软件从数字照片中量化曝光的横截面面积。这两种方法并没有导致暴露面积的显着差异。根据病例要求,背侧或掌侧入路可提供足够的近端radius骨暴露。

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