The slightly volar or dorsal subcutaneous approach to the ulnar is standard.

The approach to the radius is surgeon preference.

Most consider that the distal third of the radius is handled best through a volar approach. The proximal two thirds of the radius can be exposed either with a dorsal or volar approach. My personal preference is the dorsal approach for the proximal two thirds.

We tend to use the 3.5 mm DCP plate as shown in Image 2. Occasionally, a smaller patient requires a 2.7 mm DCP plate which seems to fit the bone better. Restoration of the radial bow cannot be over-emphasized and depends upon where and how the plate is applied after appropriate contouring.

Bone grafting in closed fractures is becoming less common. Delayed bone grafting is recommended for open injuries and bone defects.