Approach to the Ulna

Incision for the ulnar approach to the distal ulna, a straight line between extensor carpi ulnaris and flexor carpi ulnaris along the subcut
Incision for the ulnar approach to the distal ulna, a straight line between extensor carpi ulnaris and flexor carpi ulnaris along the subcutaneous border. The dorsal branch of the ulnar nerve lies close to the distal end. Image from van Rossenberg LX, van de Wall B, Diwersi N, Scheuble L, Beeres F, van Heijl M, Ferree S. Surgical fixation of distal ulna neck and head fractures. Oper Orthop Traumatol. 2023, 35(6), 329-340. CC BY 4.0.
Gray’s Anatomy cross-section of the forearm
Cross-section through the middle of the forearm. The posterior border of the ulna lies under the skin, between flexor carpi ulnaris and extensor carpi ulnaris. Image by Henry Vandyke Carter, Gray’s Anatomy (1918), Wikimedia Commons, public domain.

Position

  • Supine
  • Arm across the chest

Landmarks

  • Subcutaneous border of the ulna

Incision

  • Linear longitudinal incision over subcutaneous border of ulna

Internervous Plane

Superficial Dissection

  • Begin distally
  • Incise deep fascia along same line as skin incision
  • Down to subcutaneous border of ulna

Deep Dissection

  • Incise periosteum
  • Subperiosteal dissection

Dangers

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.