Medial and volar approach to fractures of the base of the fifth metacarpus
Stussi, J.D.; Prevost, P.; Babin, S.
Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur 88(6): 633-637
2002
ISSN/ISBN: 0035-1040 PMID: 12447135 Document Number: 550174
A medial and volar approach to the base of the fifth metacarpus for exposing finger joint fractures is described. The dorsal approach does not expose well the joint surface of the base of the fifth metacarpus, hindering reconstruction of this important articulation. Carpometacarpal mobility of the ulnar joints contributes significantly to ulnar stability and grip force. An inverted "J" incision is made along the hypothenar eminence. The insertion of the tendon of the extensor carpi ulnaris is identified and the anterior fibers are disinserted. Capsulotomy is performed in front of the anterior border of the extensor carpi ulnaris tendon. This approach exposes well the medial two-thirds of the base of the fifth metacarpus. There is no risk of injury to the ulnar vessels nor to the dorsal sensitive branch of the ulnar nerve.