Endoscopic Synovectomy of the Ulnar Bursa of the Palm of the Hand

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Endoscopic Synovectomy of the Ulnar Bursa of the Palm of the Hand Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S., Jeffrey Chun Yin Lee, M.B.B.S.(HK) Arthroscopy Techniques Volume 7, Issue 12, Pages e1257-e1261 (December 2018) DOI: 10.1016/j.eats.2018.08.012 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Endoscopic synovectomy of ulnar bursa in right hand. The patient is in the supine position with the hand on the side table. A coronal T2 magnetic resonance image of the palm of the illustrated case shows synovitis of the ulnar bursa (arrowheads). Arthroscopy Techniques 2018 7, e1257-e1261DOI: (10.1016/j.eats.2018.08.012) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Endoscopic synovectomy of ulnar bursa in right hand. The patient is in the supine position with the hand on the side table. (A) The ulnar palmar portal (UPP) is on the volar side of the fifth metacarpal neck. (B) The first web portal (FWP) is at the dorsum of the first hand web just lateral to the second metacarpal neck. Arthroscopy Techniques 2018 7, e1257-e1261DOI: (10.1016/j.eats.2018.08.012) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Endoscopic synovectomy of ulnar bursa in right hand. The patient is in the supine position with the hand on the side table. (A) Ulnar bursa endoscopy is performed through the ulnar palmar portal (UPP) and first web portal (FWP). (B) The ulnar palmar portal is the viewing portal. The ulnar bursa (UB) is identified underneath the palmar aponeurosis (PA). (C) The first web portal is the viewing portal. Inflamed synovium (IS) around the flexor tendon (T) is resected with an arthroscopic shaver (S). Arthroscopy Techniques 2018 7, e1257-e1261DOI: (10.1016/j.eats.2018.08.012) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 Endoscopic synovectomy of ulnar bursa in right hand. The patient is in the supine position with the hand on the side table. (A) Proximal synovectomy is performed with the first web portal as the viewing portal and the ulnar palmar portal (UPP) as the working portal. (B) An endoscopic view shows proximal synovectomy along the flexor tendons. (IS, inflamed synovium; S, arthroscopic shaver; T, flexor tendons.) Arthroscopy Techniques 2018 7, e1257-e1261DOI: (10.1016/j.eats.2018.08.012) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 Endoscopic synovectomy of ulnar bursa in right hand. The patient is in the supine position with the hand on the side table. The ulnar palmar portal is the viewing portal. Complete synovectomy is confirmed. (T, flexor tendons; TM, thenar muscles.) Arthroscopy Techniques 2018 7, e1257-e1261DOI: (10.1016/j.eats.2018.08.012) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions