Little Finger Flexor Tendoscopy, Endoscopy of the Ulnar Bursa and Midpalmar Space

Endoscopic Resection of Ulnar Bursa of the Palm: 2 Ulnar Portals Technique

Ulnar bursa of the hand invaginates the flexor digitorum superficialis and flexor digitorum profundus tendons of the little, ring, long, and index fingers. Distension of this bursa can have an inflammatory or infective cause. It can also originate from pathology of another site (e.g., degenerative wrist joint). Because of the tough overlying palmar aponeurosis, distended ulnar bursa can have swelling at a remote site. The distended ulnar bursa can also have compressive neuropathy to the ulnar nerve and median nerve. The purpose of this Technical Note is to describe the technical details of the 2 ulnar portals technique involving endoscopic resection of the ulnar bursa. This is indicated for symptomatic distension of the ulnar bursa, especially with hypothenar extension.

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

Synovitis of the ulnar bursa is associated with tenosynovitis of the flexor tendons. Reported causes include suppurative or tuberculous infection, rheumatoid arthritis, and pigmented villonodular synovitis. Open synovectomy requires extensive soft-tissue dissection and may result in extensive scarring. The purpose of this Technical Note is to describe the technical details of endoscopic synovectomy of the ulnar bursa of the palm of the hand. This minimally invasive approach with small incisions allows aggressive postoperative hand therapy and avoids the complications of tendon adhesions, joint contractures, and hand stiffness.