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1、尺橈骨雙骨折骨二科學習APandlateralviewsofthebothbonesfractureoftheforearm,demonstratingsignificantshorteningandrelativelysimpleobliquefracturepatterns.Thepatientispositionedsupinewiththearmpreppedanddrapedtojustabovetheelbowandatourniquetinplace.Thisfiguredemonstratesthearmheldinsupination.Notethepositi
2、onofthebicepsinsertionaswellasthepalpabletendonoftheFCRandradialartery.BICEPSTENDONRADIALARTERYFLEXORCARPIRADIALIS(FCR)AusefultechniquetomaketheskinincisionistotakeabovicordandpullittaughtfromtheradialsideofthebicepstendontotheFCRatthelevelofthewrist.Thiscanthenbeusedasatemplatefortheincision
3、line.Theincisionistakendownthroughtheskin,identifyingthefasciallayerwithcaretakennottodamageanysuperficialveinsthatmaybeintact.TheFCRtendonisclearlyvisiblethroughoutthewound,asistheradialarteryinthedistalextentofthewound.FCRRADIALARTERYAcloseupofthedistalaspectofthewounddemonstratingTheradial
4、arteryanditsvenouscommtantes.RADIALARTERYANDVENOUSCOMMTANTESFCRRADIALARTERYThefasciaontheradialsideoftheflexorcarpiradialisisreleased,exposingthedeeptissue.Theradialarterycanbefollowednowthroughouttheentireincision.Theradialarterymaybetakenineitherdirection,however,typicallyitiseasiertotaketh
5、earterytotheradialside.FCRRADIALARTERYThedeepdissectionisnowperformedbetweentheflexor-pronatormassontheulnarsideandthearteryandthemobilewadontheradialside.PRONATORFortheproximaldissection,theforearmisbroughtintosupinationandthepronator,FDSandFDParereleasedfromthevolaraspectoftheradiusFDSThepr
6、onatorisbeingreleasedfromtheradialaspectoftheradiusinasubperiostealmanner.Thissubperiostealdissectioncontinuesdistallytoreleasetheoriginofthecommonflexor.Afterexposureofthevolaraspectoftheradiusproximallyanddistally,twoclampscanbeplacedontheendsoftheboneinordertodeliverthemforcleaning.FCRRADI
7、ALARTERYEachsideofthefractureisbedeliveredinordertoexposeandcleanthecorticaledges.Thesefiguresdemonstratedeliveryofthedistalfragmentandacurvedcurettebeingusedtocleanthecorticaledge.Nocleaningshouldbeperformedwithintheintramedullarycanal,asthi
