Inside out method to develop volar arthroscopic portals of the wrist in cadaver specimens.
Three direct volar portals for wrist arthroscopy have been described previously: two radiocarpal and one midcarpal. The aim of this study was to systematically describe four volar arthroscopic portals through minimally invasive incisions using an inside out approach from known dorsal portals. Four volar arthroscopic wrist portals were studied on six hand specimens using an inside out technique: a radial radiocarpal approach (RRCA) an ulnar radiocarpal approach (URCA) a radial midcarpal approach (RMCA) and an ulnar midcarpal approach (UMCA) Each volar approach corresponded to a dorsal approach: the 3/4 portal for RRCA, 4/5 portal for URCA, dorsal radial midcarpal approach for RMCA, and dorsal ulnar midcarpal approach for UMCA. The average range of motion of the scope through the RRCA was 65deg in radial deviation and 72deg in ulnar deviation; through the URCA it was 62deg in radial deviation and 64deg in ulnar deviation; through the RMCA it was 62deg in radial deviation and 60deg in ulnar deviation, and through the UMCA it was 59deg in radial deviation and 68deg in radial deviation. No iatrogenic injuries to important anatomical structures were noted. Based on these results, it is possible to perform these four volar portals through an inside out technique with incisions mirroring the dorsal portals. They were easy to perform, safe and should be useful in ligament or bony intracarpal repair indications.
Hand surgery rehabilitation