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J Wrist Surg 2021; 10(02): 176-182
DOI: 10.1055/s-0040-1720964
Emerging Technologies and New Technological Concepts

The Volar Distal Radioulnar Portal in Wrist Arthroscopy: An 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
,
Cristobal Martinez-Andrade
3   Barcelona and Unidad de Cirugía de Mano y Miembro Superior, Hospital Quirónsalud Valencia, Hospital Dos de Maig Barcelona, Traumaunit Teknon Hospital Barcelona, Barcelona, España
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Abstract

Background Advances in wrist arthroscopy and the emergence of novel surgical techniques have created a need for new portals to the wrist. The aim of this study was to define and verify the safety of the volar distal radioulnar (VDRU) portal.

Description of the Technique The VDRU portal is located ∼5 to 10 mm proximal to the proximal wrist crease, just on the ulnar edge of flexor carpi ulnaris tendon and radial to the dorsal cutaneous branch of the ulnar nerve. The ulnar styloid marks the distal point of the portal.

Methods An anatomical study was performed on 12 upper extremity specimens of 6 human cadavers. Iatrogenic injuries of neurovascular structures potentially at risk were assessed, and the distance from the portal to these structures was measured.

Results No iatrogenic injuries of the structures at risk occurred. Mean distances from the VDRU portal to the ulnar neurovascular bundle, the radial branch of the dorsal sensory branches of the ulnar nerve (DSBUN), and the ulnar branch of the DSBUN were 9.29 ± 0.26 mm, 8.08 ± 0.25 mm, and 10.58 ± 0.23 mm, respectively. There were no differences between left and right wrists. The distances from the VDRU portal to the ulnar neurovascular bundle and the ulnar branch of the DSBUN were significantly shorter in women; this distance was not less than 7 mm in any case.

Conclusions The VDRU portal is safe, reproducible, and facilitates the implementation of various techniques related to triangular fibrocartilage complex pathology.

Keywords

wrist arthroscopy - volar distal radioulnar portal - triangular fibrocartilage complex - radioulnar joint

Note

The work was performed at the Unidad de Cirugía de Mano y Miembro Superior, Hospital QuirónSalud Valencia.




Publication History

Received: 03 June 2020

Accepted: 05 October 2020

Article published online:
17 December 2020

© 2020. Thieme. All rights reserved.

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