The Volar Intra-Articular Extended Window Approach for Intra-Articular Distal Radius Fractures

The number of distal radius fractures treated surgically is increasing, with the volar Henry approach most commonly used. Traditionally, to directly visualize intra-articular fracture reductions, a dorsal approach is also used, which can lead to increased morbidity and operative time. We describe the volar intra-articular extended window approach for intra-articular distal radius fractures, which allows direct visualization of fracture reduction from the same volar approach to the distal radius. The volar intra-articular extended window approach is performed by creating a capsulotomy in the volar wrist capsule between the long and short radiolunate ligaments while maintaining the integrity of the short radiolunate ligament to prevent postoperative carpal instability. Using this approach allows the surgeon to directly visualize the radiocarpal joint to assess reduction and ensure that no screws are placed intra-articular.