Brunner, Bunnell, or Koch and Mason? Who comes out on top? Surgeries to the volar hand require precision and careful planning to avoid complications. The Koch and Mason incision (1939) is an anterior-lateral longitudinal incision located volar to neurovascular bundles and requires dorsal retraction of neurovascular bundles after the skin is divided. It results in less bleeding and allows for a more direct approach to flexor tendons; however small nerve filaments are divided on the volar surface comprising sensation. The Bunnell incision (1949) is a mid-lateral incision dorsal to the flexion crease focused on preservation of neurovascular bundles in the volar flap. The entire length of the finger can be exposed however dorsal branches of the digital artery and nerve are divided and an indirect access to flexor tendons is provided resulting in extensive dissection. This damages structures and results in joint stiffness. The Brunner incision (1973) describes a zig-zag incision between the flexion creases based on 3 key principles: 1) reduction of flexion contractures with straight line incision that do not cross flexion creases; 2) adequate access to structures through oblique incisions between flexion creases and 3) ensuring vascularisation of flap with flap angles at 90 degrees or greater. If further exploration is needed, this excision can be extended into the palm/wrist. Still, this did not prevent volar skin sensory disturbance and development of contractures and adhesions. Multiple modifications have been made on these incisions focusing on preservation of neurovascular bundles, maximal exposure of structures and maintenance of sensation.