Trans-metacarpophalangeal traction to avoid finger-related complications during wrist arthroscopy: Feasibility study...

Some of the iatrogenic complications of wrist arthroscopy are related to the traction applied to the fingers. The aim of this work was to test whether trans-metacarpophalangeal (trans-MCP) traction would provide sufficient distraction of the radiocarpal and midcarpal joint spaces to perform wrist arthroscopy without exerting any mechanical stress on the fingers, from the metacarpophalangeal (MCP) joints to the distal phalanges. Our study included 20 cadaveric wrists mounted on an arthroscopic traction tower maintained by finger traps placed on the 2nd and 4th fingers. For each wrist, three fluoroscopic views were taken: without traction, with finger traction (78.45N), with trans-MCP traction (78.45N). The average height of the midcarpal joint space was 0.8305cm without traction, 1.037cm with finger traction, and 1.1cm with trans-MCP traction. The height of the radiocarpal joint space averaged 0.853cm without traction, 1.167cm with finger traction, and 1.187cm with trans-MCP traction. There were no differences between the heights of joint spaces between digital and trans-MCP traction. Our results show that trans-MCP traction provides distraction of the wrist joint spaces equivalent to that obtained with finger traction. However, we still need to develop a trans-MCP traction device usable in clinical practice.