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Volar Repair of Dorsal Wrist Dislocation

By William Edward Sanders, MD

The most recent addition of Green’s Operative Hand Surgery recommends repair of the ulnar aspect of the volar rent that occurs with dorsal wrist dislocation. It states that repair of the space of Poirier is not required because it is an anatomical defect. However, in approximately 6 cases I have treated operatively, I have noticed that there is a tear all the way across the volar wrist including the edges of the carpal tunnel on both the radial and ulnar aspects. There is no discernible part of this tear that appears anatomical, and instead of repair I have found that reconstruction of the ligaments with a tendon graft greatly adds in restoring stability. The graft is woven using small 90° hemostats. In one patient, this completely restored stability and internal fixation was not required.

Acknowledgments:

  1. Drawing adapted from Grants Anatomy, 1962
  2. Green’s Operative Hand Surgery, seventh edition

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