The Volar Distal Radioulnar Portal in Wrist Arthroscopy: An Anatomical Study

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 si...

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Detalles Bibliográficos
Autores: Lucas, FJ, Carratala, V, Miranda, I, Martinez-Andrade, C
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p10837
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/10837
Access Level:acceso abierto
Palabra clave:wrist arthroscopy
volar distal radioulnar portal
triangular fibrocartilage complex
radioulnar joint
Descripción
Sumario: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 similar to 5 to 10mm 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 9.290.26mm, 8.08 +/- 0.25mm, and 10.58 +/- 0.23mm, 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 7mm in any case. Conclusions The VDRU portal is safe, reproducible, and facilitates the implementation of various techniques related to triangular fibrocartilage complex pathology.