- Anatomy:
- ulnar bursae includes little finger tendon sheath which begins at terminal
phalanx & extends proximally half way up the palm;
- occassionally the distal unexpanded part of little finger tendon sheath does not communicate w/ ulnar bursae;
- in the palm, the ulnar bursae extends laterally to envelop superficial and deep tendons of ring, long, & little fingers;
- bursae extends two-three cm proximal to proximal volar wrist crease;
- variations:
- in 80% of patients, the ulnar bursae communicates w/ the
radial bursae (this accounts for the horse shoe tenosynovitis);
- occassionally index tendon sheath may extend to and communicate with the ulnar bursae;
- Tenosynovitis:
- pus involving little finger tendon sheath may progress proximally to ulnar bursa
extending from palm to a point 4-5 cm proximal to crease of wrist;
- incision:
- procedes along the radial border of 5th finger & radial border of the hypothenar eminence;
- if swelling and tenderness are present cephalad to the proximal
wrist crease & along medial border of ulna may be necessary;
- horse shoe abscess is drained by combination of little finger-ulnar bursae
and flexor pollicis-
radial bursa incisions;
