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Ulnar Wrist Denervation

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Joint Denervation

Abstract

The anatomy of the innervation of the ulnar side of the wrist joint is described, and related, primarily to triangular fibrocartilage complex injury. Nerve blocks of the appropriate nerves are described. The technical approaches to partial and total denervation of the TFCC are described and illustrated. The results of ulnar-sided wrist denervation are presented.

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References

  1. Berger RA. The anatomy of the ligaments of the wrist and distal radioulnar joints. Clin Orthop Relat Res. 2001;383:32–430.

    Article  Google Scholar 

  2. Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage tears, ulno-carpal impaction syndrome, and luno-triquetral tears. J Hand Surg. 2012;37A:1489–500.

    Article  Google Scholar 

  3. Greenberg JA. Ulnar-sided wrist pain: a master skills publication. Chicago: American Society for Surgery of the Hand Publisher; 2014.

    Google Scholar 

  4. Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist–anatomy and function. J Hand Surg. 1981;6:153–62.

    Article  CAS  Google Scholar 

  5. Wilhelm A. Zur Innervation der Gelenke der oberen Extremität. Z Anat Entwicklgsch. 1958;120:331–71.

    Article  CAS  Google Scholar 

  6. Wilhelm A. Die Gelenkdenervation und ihre anatomischen Grundlagen, Ein neures Behandlungsprinzip in der Handchirugie. Hefte Unfallheilkd. 1966;86:1–109.

    CAS  PubMed  Google Scholar 

  7. Wilhelm A. Denervation of the wrist. Tech Hand Upper Extrem Surg. 2001;5:14–30.

    Article  CAS  Google Scholar 

  8. Dellon AL, Seif SS. Neuroma of the posterior interosseous nerve simulating a recurrent ganglion: case report and anatomical dissection relating the posterior interosseous nerve to the carpus and etiology of dorsal ganglion pain. J Hand Surg. 1978;3:326–32.

    Article  CAS  Google Scholar 

  9. Dellon AL. Partial dorsal wrist denervation: resection of distal posterior interosseous nerve. J Hand Surg. 1985;10A:527–33.

    Article  Google Scholar 

  10. Dellon AL, Mackinnon SE, Daneshvar A. Terminal branch of anterior interosseous nerve as source of wrist pain. J Hand Surg. 1984;9B:316–22.

    Article  Google Scholar 

  11. Lin YT, Berger RA, Berger EJ, Tomita K, Jew JY, Yang C, et al. Nerve endings of the wrist joint: a preliminary report of the dorsal radiocarpal ligament. J Orthop Res. 2006;24:1225–30.

    Article  Google Scholar 

  12. Gupta R, Nelson SD, Baker J, Jones NF, Meals RA. The innervation of the triangular fibrocartilage complex: nitric acid maceration rediscovered. Plast Reconstr Surg. 2001;107:135–9.

    Article  CAS  Google Scholar 

  13. Cavalcante MLC, Rodrigues CJ, Mattar R Jr. Mechanoreceptors and nerve endings of the triangular fibrocartilage in the human wrist. J Hand Surg. 2004;29(3):432–5; discussion 436–438.

    Article  Google Scholar 

  14. Shigemitsu T, Tobe M, Mizutani K, Murakami K, Ishikawa Y, Sato F. Innervation of the triangular fibrocartilage complex of the human wrist: quantitative immunohistochemical study. Anat Sci Int. 2007;82:127–32.

    Article  Google Scholar 

  15. Laporte D, Hashemi SS, Dellon AL. Sensory innervation of the triangular fibrocartilage: a cadaveric study. J Hand Surg. 2014;39:1122–4.

    Article  Google Scholar 

  16. Chung KC, Zimmerman NB, Travis MT. Wrist arthrography versus arthroscopy: a comparative study of 150 cases. J Hand Surg. 1996;21A:591–4.

    Article  Google Scholar 

  17. De Smet L. Magnetic resonance imaging for diagnosing lesions of the triangular fibrocartilage complex. Acta Orthop Belg. 2005;71:396–8.

    PubMed  Google Scholar 

  18. Keogh CV, Wong AD, Wells NJ, Barbarie JE, Cooperberg PL. High resolution sonography of the triangular fibrocartilage; initial experience and correlation with MRI and arthroscopic findings. Am J Roentgenol. 2004;182:333–8.

    Article  Google Scholar 

  19. Garnham AG, Ashe M, Gropper P. Chapter 23: wrist pain. In: Brukner & Khan’s clinical sports medicine. 4th ed. Sydney: McGraw-Hill; 2013. p. 413–34.

    Google Scholar 

  20. Minami A, Ishikawa J, Suenaga N, Kasashima T. Clinical results of treatment of triangular fibrocartilage complex tears by arthroscopic debridement. J Hand Surg. 1996;21A:406–11.

    Article  Google Scholar 

  21. Westkaemper JG, Mitsionis G, Giannakopoulos PN, Sotereanos DG. Wrist arthroscopy for the treatment of ligament and triangular fibrocartilage complex injuries. Arthroscopy. 1998;14:479–83.

    Article  CAS  Google Scholar 

  22. Miwa H, Hashizume H, Fujiwara K, Nishida K, Inoue H. Arthroscopic surgery for traumatic triangular fibrocartilage complex injury. J Orthop Sci. 2004;9:354–9.

    Article  Google Scholar 

  23. Hulsizer D, Weiss AP, Akelman E. Ulna-shortening osteotomy after failed arthroscopic debridement of the triangular fibrocartilage complex. J Hand Surg. 1997;22A:694–8.

    Article  Google Scholar 

  24. Grawe B, Heincelman C, Stern P. Functional results of the Darrach procedure: a long-term outcome study. J Hand Surg Am. 2012;37:2475–80.

    Article  Google Scholar 

  25. Naff N, Dellon AL, Mackinnon SE. The anatomic course of the palmar cutaneous branch of the median nerve, including a description of its own unique tunnel. J Hand Surg. 1993;18B:316–7.

    Article  Google Scholar 

  26. Grant SA, Auyong DB. Ultrasound guided regional anesthesia. 2nd ed. London: Oxford Press; 2017.

    Google Scholar 

  27. Evans GRD, Dellon AL. Implantation of the palmar cutaneous branch of the median nerve into the pronator quadratus for treatment of painful neuroma. J Hand Surg. 1994;19A:203–6.

    Article  Google Scholar 

  28. Dellon AL. Invited commentary of mechanoreceptors and nerve endings of the triangular fibrocartilage in the human wrist by Cavalcante MLC, Rodrigues CJ, Junior RM. J Hand Surg. 2004;29A:436–8.

    Article  Google Scholar 

  29. Kupfer DM, Lee GW, Shoemaker W, Dellon AL, McSweeney J. Simplified approach to wrist denervation for triangulofibrocartilage complex disruption. J Reconstr Microsurg. 1999;15:621.. (abstract).

    Google Scholar 

  30. Wilhelm A. Die Schmerzausschaltung an der Handwurzel und an den Fingergelenken durch Denervation. In: Wachsmuth W, Wilhelm A, editors. Die Operationen an der Hand. Band X, Teil 3 der Allg u Spez Chir Operationslehre. Berlin, Heidelberg: Springer; 1972. p. 274–85.

    Google Scholar 

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Authors and Affiliations

  1. Department of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD, USA

    A. Lee Dellon

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  1. A. Lee Dellon
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Dellon, A.L. (2019). Ulnar Wrist Denervation. In: Joint Denervation. Springer, Cham. https://doi.org/10.1007/978-3-030-05538-7_5

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  • DOI: https://doi.org/10.1007/978-3-030-05538-7_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05537-0

  • Online ISBN: 978-3-030-05538-7

  • eBook Packages: MedicineMedicine (R0)

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