presents
Wheeless' Textbook of Orthopaedics
www.datatrace.com
Tracking Pixel

The ulnar neurovascular bundle at the wrist - a technical note on ³


endoscopic carpal tunnel release Cobb TK. Carmichael SW. Cooney WP. Journal of Hand Surgery - British Volume. 19B(1):24-26, 1994 Feb. The boundaries of Guyon's canal have recently been redefined by a series of anatomical dissections. These showed that the confines of this space do not extend from the pisiform to the hook of the hamate, as currently accepted. The fascial roof extends radial to the hook of the hamate, which allows the ulnar neurovascular bundle to course radial to the hamate hook. Á The position of the ulnar nerve and artery is of particular significance  for endoscopic carpal tunnel release. Most endoscopic devices are designed to divide the flexor retinaculum just to the radial aspect of the hamate hook. Utilizing cross-sectional analysis of nine cadaver specimens, we found the ulnar artery to course radial to the hamate hook in five and palmar to it in four. Therefore, the ulnar artery may be at greater risk of injury during endoscopic procedures than previously recognized.



Original Text by Clifford R. Wheeless, III, MD.