Arthroscopic mobilization for contracture of the wrist

We evaluated the clinical efficacy of arthroscopic mobilization of the wrist for release of persistent traumatic contracture.

We retrospectively reviewed 11 consecutive patients who had undergone arthroscopic mobilization after trauma. Patients included 9 men and 2 women who ranged in age from 16 to 65 years (mean, 40 years). Injuries causing contracture included 8 fractures of the distal radius, 1 Galeazzi fracture, 1 perilunate dislocation, and 1 carpal bone contusion. A single radiocarpal septum extended from the proximal fibrocartilage of the scapholunate ligament to the midradial ridge in all but 1 patient, in whom multiple fibrous bands bridged the radiocarpal joint.

Arthroscopy disclosed 3 types of radiocarpal septum-a single fibromembranous structure that completely divided the joint (type A) in 9 cases, a membranous structure with a fenestration that partially divided the joint (type B) in 1 case, and multiple bands that completely divided the joint (type C); the latter situation occurred in the last patient described earlier. Preoperatively, the arc of motion averaged 76 degrees compared with an average of 98 degrees . Postoperatively, a 22 degrees increase was noted.

Arthroscopic release of a radiocarpal septum was effective in improving range of wrist motion in patients with this finding.

Level IV, therapeutic case series.