here more items The Arthroscopy of the Wrist Dupuytren's Contracture Minimal invasive surgery in carpal tunnel syndrome Arthritis of the base of thumb, arthroplasty

The Arthroscopy of the Wrist Introduction Indications Operative Technique Results Complications

Introduction Hand-Illustration Illustration wrist The arthroscope is a thin probe which contains a small telescope. Optic fibres connect the scope with a television screen. Inserting the scope into the joint through a small cut the surgeon has a very good view into the joint. Only a large surgical approach would permit the same visibility. Thus arthroscopy allows not only a more rapid functional recovery of the joint but also a better evaluation of the joint pathology using a magnifying optic lens system. Arthroscopy of knee and shoulder is successfully practised for many years. Using more refined instruments nowadays wrist surgeons can profit by this procedure and improve their results. The wrist joint consists of: the distal radio-ulnar joint which permits rotational movements, the radio-carpal joint where radius and carpus articulate and the medio-carpal joint where the two carpal rows articulate. The single carpal bones articulate which each other so that the wrist is a complex system of more than 10 joints. These joints are stabilised by a complex system of ligaments. The triangolar fibrocartilage is a part of the radio-carpal joint and stabilises radius and ulna. Top Indications Arthroscopy image of a severe cartilage lesion of the lunate bone. Arthroscopy of the wrist is practised if diagnosis remains unclear in spite of the use of modern diagnostic methods (nuclear magnetic resonance, computerised tomography, arthrography). Often lesions of the cartilage or of the ligaments can be diagnosed only by arthroscopy. In certain cases like the lesion of the triangular fibrocartilage arthroscopy is more adequate in assessing and treating these lesions. Top Operative technique Illustration Arthroscopy The procedure is practised in regional or general anaesthesia. On the arm is applied a tourniquet so that the operation can be done in a bloodless field. Through 2-3 little cuts (0.5cm) on the back of the wrist the scope and other instruments are inserted into the joint. The joint surfaces are inspected and palpated with a little smooth hook (probe) in order to feel their consistence. In this way lesions of the cartilage and of the ligaments can be diagnosed. Certain kind of lesions can be treated directly in arthroscopy (see illustration). At the end of the operation an elastic bandage is applied. An early mobilisation of the wrist depends on the diagnosis and eventual surgical procedures done in arthroscopy. Top Results After a diagnostic procedure the wrist may be used normally after about three weeks. After surgical procedures recovery is longer and depends on diagnosis and kind of procedures. Top Risks and complications Infections are rare, mostly superficial and may be treated by antibiotics. Deep infections are extremely rare. Superficial nerves may be injured. In this case a small area of insensible skin on the back of the hand and maybe a painful spot in the scar will remain. In extremely rare cases the stump of the damaged nerve (neurinoma) must be resected. A lesion of the tendons is very rare. In such a case the tendon will be sutured. >> more information

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