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New advances in wrist arthroscopy.

Gregory I Bain1, Justin Munt, Perry C Turner

  • 1University of Adelaide, Adelaide, Australia. greg@gregbain.com

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|March 1, 2008
PubMed
Summary

Wrist arthroscopy offers enhanced visualization and expanded applications for diagnosing and treating wrist conditions. This minimally invasive technique is crucial for managing injuries like Kienböck's disease and triangular fibrocartilage complex tears.

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Area of Science:

  • Orthopaedic Surgery
  • Minimally Invasive Procedures
  • Wrist Anatomy and Biomechanics

Background:

  • Wrist arthroscopy has evolved significantly since its inception.
  • Advancements in portal techniques (dorsal and volar) enable comprehensive joint visualization.
  • The "box concept" allows for nearly panoramic views of the wrist.

Purpose of the Study:

  • To review the expanding indications and evolving techniques in wrist arthroscopy.
  • To highlight the diagnostic and therapeutic advantages of arthroscopy over traditional methods.
  • To emphasize wrist arthroscopy's role as an essential surgical tool.

Main Methods:

  • Review of current literature and surgical techniques in wrist arthroscopy.
  • Comparison of arthroscopic assessment with conventional imaging (e.g., radiographs, fluoroscopy).

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  • Discussion of arthroscopic management strategies for various wrist pathologies.
  • Main Results:

    • Arthroscopy provides superior assessment of articular damage in Kienböck's disease compared to radiographs.
    • It enables accurate diagnosis, classification, and treatment of triangular fibrocartilage complex injuries.
    • Arthroscopic evaluation of distal radius/scaphoid fractures and intercarpal ligament injuries surpasses fluoroscopy.
    • It aids in managing capsular contractures, ganglia, and ulna styloid impaction.

    Conclusions:

    • Wrist arthroscopy is a versatile and indispensable tool for orthopaedic surgeons.
    • Its indications continue to broaden, encompassing diagnostic, reparative, reconstructive, and bony procedures.
    • Complications are infrequent, underscoring its safety and efficacy.