An assistant is usually required to aid supination of the forearm during volar fixation of a distal radius fracture. We describe a simple technique to maintain supination when an assistant is unavailable. The thumb is passed through the ring of a Trethowan retractor with the spike passed beneath the hand at the level of the metacarpal bases (Fig 1). This maintains supination without obscuring intraoperative imaging, unlike a lead hand retractor. This may free the scrub nurse from having to aid with supination when an assistant is not available and can reduce operative time.
Figure 1.
Lower arm before and after thumb has been passed through the ring of a Trethowan retractor