[Anatomy of the articular nerves of the wrist. Implications for wrist denervation techniques]

The knowledge of the anatomy of the wrist articular nerves is at the base of the denervation technique. After a dissection of 12 adult wrists, we specify the situation and the relation of these nerves at the level where they are accessible to a surgical approach. The 10 articular branches of Wilhelm are described successively. The posterior interosseous is the most voluminous and most constant. Some branches need a specific surgical approach: anterior and posterior interosseous nerve, lateral cutaneous nerve, articular branch of the first web. Other nerves are cut blindly after skin undermining (perforating branches from cutaneous nerves). Some branches appear inaccessible to a cautious surgery because they are closely tight to other motor branches (deep branches of the cubital nerve). Finally some branches described by Wilhelm were not found in our dissections: branches of the median palmar cutaneous nerve, and direct branch of the cubital nerve.