title: Surgical approach to the triangular fibrocartilage complex.
abstract: There are few descriptions of the surgical exposure of the ulnar aspect of the wrist. The anatomy of the dorsoulnar aspect of the wrist was explored in 7 cadaver wrists with special attention to developing a surgical approach to the dorsum of the radio-ulno-carpal joint. Using the experience from previous authors and the knowledge gained from our cadaveric dissections, a surgical approach was designed that provides wide exposure of the dorsoulnar aspect of the wrist. The anatomic layers are dissected in a distinct pattern that allows preservation of the extensor carpi ulnaris and its sheath as well as a strong closure of each layer and restoration of the anatomy. Minimal postoperative immobilization is required, and rehabilitation can be started as early as 2 weeks postoperatively. This approach provides access to the distal radioulnar joint, triangular fibrocartilage complex, distal ulna, and lunotriquetral joint, thus allowing multiple possible procedures through a single, universal approach.
authors.affiliation: Hand and Upper Extremity Surgery; Institut Kaplan; Barcelona, Spain. garciaelias@infonegocio.com.
authors.forename: Marc
authors.initials: M
authors.lastname: Garcia-Elias
authors.forename: Donna E
authors.initials: DE
authors.lastname: Smith
authors.forename: Manuel
authors.initials: M
authors.lastname: Llusá