Assessing Hand Perfusion Via Video Using Pigment Enhancement Technology

PURPOSE: Ulnocarpal joint denervation has been a suc-cessful treatment for several patients with ulnar-sided wrist pain. The purpose of this study was to characterize the articular branches of the dorsal branch of the ulnar nerve (DBUN), and to validate a technique for selective periph-eral nerve blockade. METHOD: We performed simulated local anesthetic injection using 0.5 mL of 0.5% methylene into the subcutaneous tissue at a point midway between the palpable borders of the pisiform and ulnar styloid. We then dissected the DBUN, characterized its articular branching pattern, and measured staining intensity of the DBUN and ulnar nerve proper rela-tive to a standard. RESULTS: Among 11 specimens, the DBUN provided an average of 1 (range 0-2) ulnocarpal branches and 1 (range 0-2) carpometacarpal articular branches. A carpal articular branch from the DBUN was universally present. Simulated local anesthetic injection successfully stained 100% of the DBUN carpal articular branches at or proximal to their takeoff and did not stain any proper ulnar nerves. In all specimens, the DBUN supplied at least one carpal articular branch. CONCLUSION: A point midway between the palpable border the pisiform