Volar Ulnar Approach

Volar ulnar approach to the distal radius and carpus

Nicholas Pourgiezis, Gregory I Bain, James H Roth, Michael R Woolfrey.

Modbury Public Hospital, The University of Adelaide, Adelaide, South Australia, Australia. St Joseph's Health Centre, The University of Western Ontario, Ontario, Canada

This safe and extensile approach provides excellent exposure of the flexor tendons in the palm, distal radius, distal radioulnar joint and carpus, and can be used to expose any pathology on the volar aspect of the wrist. Using a volar ulnar incision, the ulnar neurovascular bundle is identified and extensively released. The transverse carpal ligament is divided at its ulnar attachment, and the finger flexor tendons are retracted radially to expose the volar wrist capsule and the pronator quadratus. These latter structures can be divided to expose the carpus and distal radius, respectively. Forty-four patients were reviewed, and 46 procedures were performed. The approach was used for a spectrum of indications and often included complex injuries or disorders of the wrist. Patients reported a low level of pain and a high level of satisfaction. There were no neurovascular complications.

Can J Plast Surg 1999; 7(6): 273-78