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J Wrist Surg 2024; 13(02): 176-180
DOI: 10.1055/s-0043-1771439
Emerging Technologies and New Technological Concepts

The Medial Triquetrohamate Portal: A New Portal in Wrist Arthroscopy. Anatomical Study

Francisco J. Lucas 
1   Unidad de cirugía de mano y miembro superior, Hospital QuirónSalud Valencia, Valencia, España
,
Vicente Carratalá
1   Unidad de cirugía de mano y miembro superior, Hospital QuirónSalud Valencia, Valencia, España
,
Ignacio Miranda
2   Servicio de Cirugía Ortopédica y Traumatología, Hospital Arnau de Vilanova Valencia, Valencia, España
,
Sergio Pombo Alonso
1   Unidad de cirugía de mano y miembro superior, Hospital QuirónSalud Valencia, Valencia, España
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Abstract

Introduction Continuing advances in wrist arthroscopy and better understanding of carpal conditions have created the need to design new wrist access portals that facilitate the implementation of new surgical techniques. The aim of this study was to define and verify the safety of the medial triquetrohamate (MTH) portal.

Description of the technique The MTH portal is located about 5-10 mm ulnar and 2-3 mm distal to the midcarpal ulnar portal, ulnar to the extensor digitorum communis (EDC) tendon of the fourth and fifth fingers, and radial to the extensor digiti quinti (minimi) (EDQ) tendon.

Methods An anatomical study was performed on 15 upper limb specimens from 15 human cadavers. Iatrogenic injuries to potentially at-risk neurovascular and tendinous structures were assessed, and the distance from the portal to these structures was measured.

Results There were no iatrogenic injuries to the structures at risk. Mean distances from the MTH portal to the EDC tendon of the fourth and fifth fingers and to the EDQ tendon were 4.67 ± 0.35 mm and 7.27 ± 0.18 mm, respectively. No differences were observed between the left and right wrists. The distance from the MTH portal to the dorsal sensory branch of the ulnar nerve was 15.07 ± 0.44 mm. The structure with the highest risk of injury was the EDC tendon of the fourth and fifth fingers, with a distance of less than 5 mm.

Conclusions The MTH portal is safe, reproducible and facilitates the implementation of various techniques related to midcarpal pathology.

Keywords

wrist arthroscopy - medial triquetrohamate portal - midcarpal joint


Publication History

Received: 08 May 2023

Accepted: 28 June 2023

Article published online:
28 July 2023

© 2023. Thieme. All rights reserved.

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