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Dry Wrist Arthroscopy: Technique and Rationale.

Rachel Phillips1, Stephanie Choo2, Bryce Fletcher2

  • 1Department of Orthopaedic Surgery, University of Missouri System, Columbia, Missouri, U.S.A..

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Summary

Dry wrist arthroscopy (DWA) offers advantages like reduced fluid extravasation and easier open procedures for wrist injuries. This minimally invasive technique aids in diagnosing and treating TFCC tears, ligament injuries, and fractures.

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Area of Science:

  • Orthopaedic Surgery
  • Minimally Invasive Procedures
  • Wrist Arthroscopy

Background:

  • Wrist arthroscopy is a standard minimally invasive technique for diagnosing and treating wrist conditions.
  • Traditional wrist arthroscopy uses constant fluid inflow for joint insufflation and visualization.
  • Fluid extravasation and visualization obstruction are potential drawbacks of traditional wet arthroscopy.

Purpose of the Study:

  • To introduce and evaluate Dry Wrist Arthroscopy (DWA) as an alternative technique.
  • To highlight the advantages and applications of DWA in various wrist pathologies.
  • To assess the feasibility and learning curve of DWA for surgeons.

Main Methods:

  • Description of Dry Wrist Arthroscopy (DWA) technique, performed without fluid infusion.
  • Application of DWA in the assessment and management of triangular fibrocartilage complex (TFCC) tears, ligamentous injuries, and fractures.
  • Utilizing DWA for diagnosing scaphoid nonunions and in chronic settings.

Main Results:

  • DWA offers benefits such as no fluid extravasation, improved visualization by reducing synovial villi obstruction, and decreased risk of compartment syndrome.
  • Facilitates easier performance of concomitant open procedures and reduces the risk of fluid displacement of bone grafts.
  • DWA is effective in managing soft-tissue and osseous injuries, including TFCC tears, ligamentous injuries, and fractures.

Conclusions:

  • Dry Wrist Arthroscopy (DWA) is a valuable technique for diagnosing and treating a range of wrist conditions.
  • Its advantages make it a potentially useful addition to the practice of surgeons already performing wrist arthroscopy.
  • While DWA has disadvantages like heat generation and instrument clogging, its benefits often outweigh them for specific orthopaedic conditions.