Approaches｜桡骨远端改良Henry入路

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前言：       桡骨前侧入路可安全显露桡骨全长，可用于桡骨相关的ORIF、骨肿瘤活检、骨不连翻修植骨、骨髓炎病灶清除等。该入路最早由Henry描述，故又称Henry入路。————注：内容来自AO Trauma网站

1.IntroductionThe modified Henry approach utilizes the interval between flexor carpi radialis tendon and the radial artery, whereas the classical Henry approach goes between brachioradialis and the radial artery. The modified approach is medial to the radial artery.（桡骨远端经典Henry入路（图1）在肱桡肌与桡动脉间进入，改良Henry（图2）入路在桡侧腕屈肌与桡动脉间进入。）△图1△图2
2.Skin incision and exposureThe radial artery is retracted laterally and the flexor carpi radialis is retracted in a medial direction. The pronator quadratus muscle is then exposed by retracting medially the muscle belly of the flexor pollicis longus.


Exposure of the bone is completed by incision of the lateral and distal edges of pronator quadratus muscle leaving a small lateral cuff on the radius to allow for subsequent repair.This now allows elevation of the muscle belly from the anterior aspect of the distal radius.
3.Wound Closure

The pronator quadratus should be placed over the plate. Every attempt should be made to reattach the horizontal limb of the pronator quadratus elevation to the capsule. If possible, it should be reattached to its radial insertion.

In certain instances, for example with marked forearm swelling, the wound may have to be left open. There are different techniques to overcome such difficulties (eg, elastic closure, vacuum assisted closure, petroleum jelly gauze, skin substitute, etc).

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