Surgical exposures of the wrist and hand

The neurovascular anatomy of the carpus and hand is complex. Therefore, precise exposures are required to avoid iatrogenic injury. In general, dorsal exposures are more forgiving than volar exposures because major neurovascular structures lie on the volar aspect of the hand and fingers; however, volar, ulnar, and radial approaches to the carpal bones are also commonly used. Exposure of the metacarpals and phalanges is relatively straightforward by comparison. Exposure of the carpus and hand is also complicated by the dense and often superficial innervation network. Therefore, a thorough knowledge of the pertinent anatomy is required for safe surgical approaches to the wrist and hand.