Operative approaches: Forearm

Volar approach to the Radius (Henrys)

• In an appropriately marked and consented, anaesthetised patient. I would complete the WHO checklist.
• Set up: Supine, II available, arm board, exangunated, Torniquette to 250mmHg
• Internervous plane: Radial nerve and median nerve
• Incision variable length along line lateral to biceps tendon to radial styloid
• Superficial dissection: Plane between brachioradialis and flexor carpi radialis. Move proximally to develop a plane between pronator teres and brachioradialis. ID the superficial radial nerve beneath the Bradioradialis.
• Deep dissection: Follow the biceps tendon to its insertion. Radial to its insertion incise the bursa to aceess the proximal part of the radial artery.
• supinate the forearm to displace the PIN radially and bring the origin of the supinator muscle. 

Volar approach to the Radius (Henrys)

• In an appropriately marked and consented, anaesthetised patient. I would complete the WHO checklist.
• Set up: Supine, II available, arm board, exangunated, Torniquette to 250mmHg
• Internervous plane: Radial nerve and median nerve
• Incision: Along a line between the radial styloid to lateral border of biceps tendon
• Superficial dissection: Plane between the brachioradialis and flexor carpi radialis
• Deep dissection: Pronate the arm to ID origin of the pronator teres detach the insertion and retract medially. 

Flexor Carpi Radialis approach