Distal Radius Fracture ORIF (Volar Plate)

Fixation of a distal radius fracture with a volar locking plate through a volar approach, on a hand table under an upper-arm tourniquet and mini C-arm. Small parts and many images: the surgeon checks every screw near the joint.

Position and prep

Supine, arm on a hand table; upper-arm tourniquet; mini C-arm at the end of the hand table.

Prep: Hand and forearm to the tourniquet.

Room setup

Hand table
Mini C-arm (or C-arm) and lead
Upper-arm tourniquet (set and tested)
Power drill and wire driver

Implants

Volar locking distal radius plate (anatomic, sized to the patient)
Locking and non-locking screws or pegs
K-wires for provisional fixation

Instruments

Small fragment or hand set: drill guides (including threaded locking guides), depth gauge, screwdrivers
Small Hohmann retractors, Senn and Ragnell retractors
Freer elevator
Small Weitlaner
K-wires and wire driver
Small pointed reduction clamp
Hand tray for the soft tissue

In the free instrument guide: Hohmann retractor, Senn Retractor, Weitlaner Retractor, Adson Forceps, Drill.

How the case runs

Time-out, including laterality; tourniquet up
Volar incision; the surgeon protects the radial artery and the median nerve
Elevate the pronator quadratus; expose the fracture
Reduce with traction and provisional K-wires; images

The rest of the case is in the app

5 more steps, the Mayo setup, draping order, closing, pearls, and a three-stage “what would you do next?” case. Free to start.

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Clinically reviewed by William Guglielmo on October 15, 2026. Generic teaching content. Your surgeon's preference card, the implant system's technique guide and facility policy always come first.