A study of clinical anatomy of the safe zone for the volar approach for wrist arthroscopy

Abstract

Objective: The current study was to perform an anatomical observation of the volar approach for wrist arthroscopy and to establish the safe zone for this approach.

Methods: Eight preserved specimens and 2 fresh specimens were used to simulate the medial-to-lateral operation and to mark the volar approach. Based on anatomical measurements of the volar approach, the closest distances from the 1/2, 6R, 6U, VR, VR' and VU approaches to the adjacent important structures were established.

Results: The closest distance from the 1/2 approach to the superficial branch of the radial nerve was 2.4±1.5mm. The closest distances from the 6U and 6R approaches to the dorsal carpal branch of the ulnar nerve were 16.2±1.3mm and 9.0±2.4mm, respectively. The closest distances from the VR and VR' approaches to the palmar cutaneous branch of the median nerve were 6.7±1.1mm and 2.8±0.9mm, respectively; the closest distances to the radial artery were 6.3±4.0mm and 10.0±3.4mm, respectively. Moreover, both of the two approaches passed through the base of the flexor carpi radialis tendon. The closest distance from the VU approach to the ulnar artery and flexor digitorum profundus tendon were 3.3±1.4mm and 0.3±2.5mm, respectively.

Conclusions: In conclusion, a safe zone could be located for the establishment of the volar approach for wrist arthroscopy.

Level of evidence: III; retrospective study with no control group.

Keywords: Anatomy; Approach; Arthroscopy; Volar; Wrist.