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Wrist arthroscopy through a volar radial portal
Summary
A volar radial portal for wrist arthroscopy is safe and identifies additional pathology in 30% of patients, including scapholunate interosseous ligament tears. This approach is recommended for radial-sided wrist pain.
Area of Science:
- Orthopedic surgery
- Anatomy
- Arthroscopy
Background:
- Dorsal portals are standard for wrist arthroscopy.
- Volar approaches may offer advantages for specific pathologies.
- Understanding neurovascular anatomy is crucial for portal safety.
Observation:
- Cadaver dissections revealed a >3mm safe zone around the volar radial portal.
- Retrospective review of 30 patients showed no neurovascular complications.
Findings:
- Volar wrist arthroscopy identified previously unseen pathology in 30% of patients.
- This included dorsal capsular structures and palmar scapholunate interosseous ligament pathology.
- Specific findings included synovitis, radioscapholunate ligament avulsion, and dorsal radiocarpal ligament tears.
Implications:
- The volar radial portal offers a safe and standardized method for examining the radiocarpal and midcarpal joints.
- It enhances visualization of pathology missed by dorsal portals.
- Consideration for radial-sided wrist pain is recommended.