Ulnar Nerve – Volar Approach

Ulnar nerve – volar approach

* position – supine with tourniquet

* incision
– curved incision following radial border of hypothenar eminence
– cross wrist joint obliquely at 60 deg
– extend incision onto volar aspect of distal forearm

* no internervous plane

* dissection
– identify FCU tendon
– incise fascia of tendon on radial border
– retract FCU ulnarly to expose ulnar n. & art.
– follow NV bundle distally & incise volar carpal ligament – decompresses Guyon’s canal

* dangers
– ulnar n.
> use care when incising fascia on radial side of FCU
> use care when incising volar carpal lig. distally

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