Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table with the arm placed on an arm board to allow for optimal access to the forearm.

Anatomical surgical approach:  A volar Henry approach was utilized, involving an incision along the radial aspect of the forearm. The interval between the radial artery and brachioradialis was exploited, with careful protection of the radial nerve. The supinator muscle was elevated from the ulnar border of the radius while maintaining full supination of the proximal segment to avoid injury to the PIN. The ulna was approached through a separate incision, allowing for direct access to both fracture sites.

Intraoperatively, it was noted that plating up to the bicipital tuberosity required precise anatomical knowledge to avoid complications. The segmental nature of the ulna fracture necessitated careful alignment and fixation of both segments to restore forearm stability.

Postoperative protocol:   Postoperative rehabilitation included immobilization in a splint for 2 weeks, followed by gradual range of motion exercises. Weight-bearing activities were restricted for 6 weeks, with progressive strengthening exercises introduced thereafter.

Follow up:   Not specified

Orthopaedic implants used:   Volar locking plate for proximal radius, dual plating for segmental ulna fracture.