Anatomic Relation of Dorsal Wrist Arthroscopy Portals and Superficial Nerves: A Cadaveric Study

Purpose

The aim of this cadaveric study was to assess and compare the distance of commonly used dorsal wrist portals to the dorsal ulnar and radial superficial nerves and their branches.

Methods

Twenty embalmed cadaveric upper limbs were dissected, exposing the nerves and tendons, and wrist arthroscopy portal sites were marked with pins. The horizontal distance between the portals and closest nerve branch was measured with a digital caliper. Statistical analysis of the data was performed with SPSS software for Windows (version 11.5; SPSS, Chicago, IL) by use of Friedman tests and Wilcoxon signed rank tests.

Results

The median distance of the nearest nerve branch to portal 1-2 was 1.82 mm; portal 3-4, 4.85 mm; portal 4-5, 16.13 mm; portal 6U, 2.47 mm; and midcarpal radial portal (MCP), 6.65 mm. The 4-5 portal was safer than the 1-2 portal (P < .0001), 3-4 portal (P = .015), MCP (P = .001), and 6U portal (P < .0001). The MCP was safer than the 1-2 portal (P = .01), 3-4 portal (P = .019), and 6U portal (P = .003).

Conclusions

The 4-5 portal is further away from a nerve branch than any other portal, followed by the MCP.

Clinical Relevance

The results of this study may be of use in the planning of wrist arthroscopy.

Key Words: Wrist portals, Superficial nerves