The radial shaft has a characteristic lateral bow, maximal at its mid-point, which is essential for full forearm rotation. Its anterior surface provides the origin of flexor pollicis longus and part of flexor digitorum profundus. Pronator teres inserts at the lateral mid-shaft. The posterior surface gives rise to abductor pollicis longus and extensor pollicis brevis distally.
Radial shaft fractures must be fixed with a plate that precisely restores the radial bow, as even minor flattening reduces forearm rotation by up to 20%. The Henry and Thompson approaches provide anterior and posterior access respectively. Galeazzi fracture combines a radial shaft fracture with DRUJ disruption and requires ORIF of the shaft to reduce the DRUJ.
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