Hand approaches

Question 1

What are the indications to use the dorsal approach to the hand?

Answer 1

• Synovectomy
• Wrist fusion
• excision of lower end of radius
• Proximal row carpectomy
• ORIF of distal radius- intra-articular dorsal lip
• carpal fractures and dislocations

Question 2

What are the dangers to the dorsal approach to the hand?

Answer 2

• Radial nerve
• Radial artery
• Posterior interosseous nerve

Question 3

Where do u make incision for wrist?

Answer 3

• 8cm midline halfway between radial and ulnar styloid
  
  • can extend prox/distally as required
• No true intermuscular plane
  
  • dissection between 3rd and 4th extensor compartments
• Incise fat inline w skin incision
• expose Extensor retinaculum
• release EPL from 3rd dorsal extensor compartment and retract radially
• Subperiosteally lift the 4th compartment off the distal radius.