Technique of Carbon Dioxide Insufflation of the Wrist During Arthroscopic Bone-Grafting Procedures

Chronic scaphoid fractures are conventionally treated with arthroscopic bone grafting. Traditional dry wrist arthroscopy avoids graft displacement caused by fluid irrigation but faces challenges such as obscured visibility from bleeding and limited operative space. This study introduces a carbon dioxide insufflation technique using pulsed gas perfusion at 5 kPa pressure and 10 mL/min flow rate. By replacing the dry environment, carbon dioxide insufflation dynamically clears intraoperative bleeding, stabilizes the visual field, and expands the joint cavity for improved instrument maneuverability. Preliminary outcomes demonstrate reduced procedural interruptions and enhanced graft compaction compared with dry arthroscopy, while avoiding the risks of graft displacement associated with fluid-based methods. This technique combines the stability of a dry surgical field with the advantages of gas-mediated visualization, offering a promising alternative for arthroscopic bone grafting.