title: [Medial and volar approach to fractures of the base of the fifth metacarpus].
abstract: 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.
authors.affiliation: Service de Chirurgie orthopédique et Traumatologique (Pr. Babin), Hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg Cedex, France.
authors.forename: J D
authors.initials: JD
authors.lastname: Stussi
authors.forename: P
authors.initials: P
authors.lastname: Prevost
authors.forename: S
authors.initials: S
authors.lastname: Babin
mesh_terms: D004210:Dissection / Q000379:methods*; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D011859:Radiography; D016059:Range of Motion, Articular; D012307:Risk Factors; D016896:Treatment Outcome