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Universal Dorsal Approach of the Wrist

Ciais, Grégoire MD; Waitzenegger, Thomas MD; Parot, Catalina MD; Leclercq, Caroline MD

Techniques in Hand & Upper Extremity Surgery: September 2015 - Volume 19 - Issue 3 - p 124–128
doi: 10.1097/BTH.0000000000000092

The ideal dorsal wrist approach has to provide the best exposure while preserving sensitive dorsal nerve branches, dorsal veins, and skin integrity. Longitudinal incision is mostly used in the wrist surgery. Few anatomic or clinical studies have described transverse dorsal approach following Langer’s lines. We present a universal transversal skin incision, the design of which meets the requirements of a dorsal wrist approach. It is adjustable with the radial and ulnar extension and respects Langer’s lines, nerves, and veins. We conducted both an anatomic, clinical, and a retrospective study. For the anatomic part, we performed a cadaveric study on the wrist. For the clinical part of the study, we analyzed clinical results for 10 consecutive patients who underwent a universal dorsal wrist approach for various surgical procedures by the same surgeon. For the last part, we reviewed the patients operated during the past 5 years with this approach for different procedures in the wrist.

Institut de la Main, Clinique Jouvenet, Paris, France

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Grégoire Ciais, MD, 3 Rue Maître Albert, Paris 75005, France. E-mail:

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