Partial Wrist Denervation via Single Volar Approach: New Technique With a Case Presentation

Background: Selective denervation of sensory nerve branches to the wrist is a palliative surgical treatment option for patients with chronic wrist pain when preserving the range of motion and function is preferred. AIN and PIN were transected both ways, ventral and dorsal. Patients and methods: This study was carried out in level one-microsurgery unit to report on technique of partial wrist denervation using a single volar approach, which eliminates the need for other separate dorsal incision to approach the posterior interosseous nerve. The case presented in the current study is a patient with Kienbocks disease planned for radial shortening and wrist denervation. Technique: Depending on solid anatomic landmarks reported in literature, the course of the AIN, PIN, interosseous artery, and proximal extent of the pronator quadratus muscle were identified through modified Henry’s approach to the forearm. An ideal incision zone to the interosseous membrane is located 8 cm proximal to the radial styloid, respectively, 1 cm proximal to the proximal border of the pronator quadratus. Conclusions: The current investigation clearly indicates that a volar approach for a combined transaction of AIN and PIN can be performed. This technique may limit postoperative pain, need for analgesia, and enhance postoperative protocol.