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Wrist arthroscopy

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https://www.readbyqxmd.com/read/28808768/high-resolution-mri-3t-mri-in-diagnosis-of-wrist-pain-is-diagnostic-arthroscopy-still-necessary
#1
Sabine Ochman, B Wieskötter, M Langer, V Vieth, M J Raschke, C Stehling
INTRODUCTION: 3T MRI has become increasingly available for better imaging of interosseous ligaments, TFCC, and avascular necrosis compared with 1.5T MRI. This study assesses the sensitivity and specificity of 3T MRI compared with arthroscopy as the gold standard. PATIENTS AND METHODS: Eighteen patients were examined with 3T MRI using coronal T1-TSE; PD-FS; and coronal, sagittal, and axial contrast-enhanced T1-FFE-FS sequences. Two musculoskeletal radiologists evaluated the images independently...
August 14, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28737618/evaluation-of-ulnar-sided-wrist-pain
#2
Manuel F DaSilva, Avi D Goodman, Joseph A Gil, Edward Akelman
Determining the etiology of ulnar-sided wrist pain is often challenging. The condition may be acute or chronic, and differential diagnoses include injuries to the ulnar carpal bones, ligament tears, tendinitis, vascular conditions, osteoarthritis and systemic arthritis, and ulnar nerve compression. An anatomically based, methodical physical examination coupled with provocative maneuvers, including piano key, ulnar impaction, shuck, foveal stress, and extensor carpi ulnaris synergy tests, further defines the differential diagnosis...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28643521/a-novel-all-inside-arthroscopic-technique-for-radial-sided-triangular-fibrocartilage-complex-tears-a-case-report-and-review-of-literature
#3
Michael T Edgerton, Robert C Kollmorgen
BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28624019/scapholunate-dissociation-diagnostics-made-easy
#4
K C A L Cheriex, G S I Sulkers, M P Terra, N W L Schep, B J P L van Aard, S D Strackee
Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. SLD can cause osteoarthritis of the wrist. Recently a study was published that shows cineradiography to be an excellent radiological imaging technique for diagnosing SLD at a tertiary centre for hand and wrist surgery [1]. As the quality of these results can be influenced by the expertise of the operator and observer of the cineradiographic studies, the aim of this study was to determine if these results were reproducible at a secondary centre for hand and wrist surgery with less expertise in wrist cineradiography...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28594695/wrist-arthroscopy-in-children-and-adolescent-with-chronic-wrist-pain-arthroscopic-findings-compared-with-mri
#5
Ashok L Ramavath, P N Unnikrishnan, Harvey L George, Paramasivam Sathyamoorthy, Colin E Bruce
BACKGROUND: Wrist arthroscopy is a dynamic diagnostic procedure and its indications are growing as a treatment modality in the adult population. The aim of the study was to retrospectively report our series of pediatric and adolescence with chronic wrist pain, with or without wrist instability who underwent wrist arthroscopy after failing at least 4 months of conservative management. Our secondary aim was to report the sensitivity and specificity of clinical examination and magnetic resonance imaging evaluation for various injury subgroups against the gold standard of the arthroscopic findings...
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28488454/diagnostic-accuracy-of-single-compartment-magnetic-resonance-arthrography-in-detecting-common-causes-of-chronic-wrist-pain
#6
A M Asaad, A Andronic, M P Newby, J W K Harrison
We reviewed a series of 50 consecutive wrist arthroscopy patients who had been investigated pre-operatively by direct magnetic resonance arthrography and calculated the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of magnetic resonance arthrography in detecting full-thickness triangular fibrocartilage complex tears, intrinsic carpal ligamentous lesions, wrist synovitis and chondral lesions in the radiocarpal joint. The sensitivities of magnetic resonance arthrography in detecting central triangular fibrocartilage complex tears, peripheral triangular fibrocartilage complex tears, scapholunate ligament tears, lunotriquetral ligament tears, dorsal synovitis and radiocarpal chondral lesions were 89%, 63%, 71%, 100%, 32% and 65%, respectively, and its specificities in detecting these lesions were 91%, 98%, 89%, 94% 94% and 97%, respectively...
March 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28472593/cost-description-of-clinical-examination-and-mri-in-wrist-ligament-injuries
#7
Jonny K Andersson, Elisabeth Hansson-Olofsson, Jón Karlsson, Jan Fridén
OBJECTIVE: The total number and cost of wrist MRIs in the catchment area of the Västra Götaland Region in Sweden (population 1 723 000) during 1 year was analysed, together with the number and content of referrals. METHODS: Six radiology departments reported the numbers and rate of all MRI investigations intended to diagnose wrist ligament injuries (n = 411) and other injuries to the wrist. RESULTS: The additional cost of the difference between MRIs and a clinical examination by a hand surgeon, plus indirect costs for patients with suspected wrist ligament injuries, was calculated as 957 000 euros...
May 4, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28465198/trans-metacarpophalangeal-traction-to-avoid-finger-related-complications-during-wrist-arthroscopy-feasibility-study-with-20%C3%A2-cadaver-wrists
#8
J J Hidalgo Diaz, G Asmar, L Buendia, S Hendriks, S Facca, P Liverneaux
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...
March 30, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28344533/diagnostic-wrist-arthroscopy-for-nonspecific-wrist-pain
#9
Amin Mohamadi, Femke M A P Claessen, Sezai Ozkan, Gregory P Kolovich, David Ring, Neal C Chen
Background: This study addresses the prevalence of discrete pathophysiology accounting for patients' symptoms during diagnostic wrist arthroscopy in individuals with wrist pain without a specific preoperative diagnosis. Secondarily, we determined the number and type of surgeries subsequent to diagnostic wrist arthroscopy. Methods: Between January 2000 and January 2015, 135 diagnostic wrist arthroscopies were performed by 12 surgeons in 3 urban academic hospitals. We recorded the diagnostic findings of diagnostic wrist arthroscopy and any subsequent surgeries...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28259281/diagnosis-and-arthroscopic-management-of-dorsal-wrist-capsular-impingement
#10
Andrew P Matson, Travis J Dekker, Alexander J Lampley, Marc J Richard, Fraser J Leversedge, David S Ruch
PURPOSE: Dorsal wrist capsular impingement (DWCI) is characterized by pain attributable to impingement of dorsal capsular tissue during wrist extension. The diagnostic criteria and management algorithm for this condition have not been well established. The aims of our study were (1) to retrospectively review the clinical presentation and arthroscopic findings of patients treated surgically for DWCI and (2) to evaluate the outcomes of arthroscopic debridement for this condition. METHODS: A total of 19 patients were treated with arthroscopic debridement for isolated DWCI from 2006 to 2015 by two surgeons (M...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28237081/incidence-of-posterior-interosseous-nerve-trauma-during-creation-of-the-3-4-wrist-arthroscopy-portal-in-cadavers
#11
Andre Eu-Jin Cheah, Wei Le, Jeffrey Yao
PURPOSE: To describe histologic evidence of nerve trauma during the creation and use of the 3-4 portal. METHODS: Fourteen fresh-frozen cadaveric wrists were mounted on a custom-built frame that simulated a wrist arthroscopy traction tower. After the 3-4 portal was created in the usual manner, the skin was dissected off to identify possible trauma to the posterior interosseous nerve (PIN). Specimens were categorized into those where there was clearly no trauma to the PIN and those where trauma was possible...
February 22, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28187026/an-algorithmic-approach-to-the-suspected-septic-wrist
#12
Jeffrey R Claiborne, Leslie G Branch, Michael Reynolds, Anthony J Defranzo
An acutely painful, erythematous wrist can be due to a variety of pathologic processes, including crystalline arthropathy, infection, trauma, osteoarthritis, and systemic disease. The broad differential diagnosis of the inflamed wrist and nonspecific clinical findings make accurate diagnosis challenging. There is no published clinical or laboratory criterion that reliably differentiates septic wrist arthritis from a sterile inflammatory arthropathy. For septic joint patients, long-term results are notably poorer in patients with a delay in treatment, therefore establishing evidenced-based guidelines deserves attention...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28119801/the-parc-lesion-a-proximal-avulsion-of-the-radiocarpal-capsule
#13
Francis Bonte, Christophe L Mathoulin
Purpose A proximal avulsion of the radiocarpal capsule (PARC) is a cause of persisting posttraumatic wrist pain. This lesion is often overlooked and left untreated during wrist arthroscopy. Materials and Methods A record review was performed on 13 patients with this lesion who underwent diagnostic wrist arthroscopy after failed conservative treatment. We retrospectively reviewed the results of an arthroscopic repair method in 13 patients. Results In 11 of the 13 consecutive cases the lesion was sutured using an arthroscopic dorsal capsule-ligamentous repair technique...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119797/microfracture-for-ulnar-impaction-syndrome-surgical-technique-and-outcomes-with-minimum-2-year-follow-up
#14
David Kaufman, Jennifer Etcheson, Jeffrey Yao
Purpose The purpose of this study is to assess functional and patient-reported outcomes after lunate microfracture for management of lunate chondral lesions in the setting of ulnar impaction syndrome. Methods This was a retrospective review of all patients undergoing wrist arthroscopy for triangular fibrocartilage complex pathology by one surgeon from 2007 until 2010. Disabilities of the arm, shoulder, and hand (DASH) scores were assessed preoperatively and at minimum 2-year follow-up. Patient-rated wrist evaluation and bilateral wrist range of motion, grip strength, and key pinch strength were assessed at final follow-up...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119793/preventable-repeat-wrist-arthroscopies-analysis-of-the-indications-for-133-cases
#15
Steffen Löw, Christian K Spies, Frank Unglaub, Jörg van Schoonhoven, Karl-Josef Prommersberger, Marion Mühldorfer-Fodor
Background Frequently, patients undergo repeated wrist arthroscopies for single wrist problems. Purpose The purposes of this study were to assess the indications for repeat wrist arthroscopies and to identify potentially preventable procedures. Methods For this retrospective, two-center study, the electronic patient records were examined for patients, who underwent repeat wrist arthroscopy in a 5-year period. The cases were sorted by the underlying pathologies and the causes that necessitated repeat arthroscopies...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28080158/diagnosing-central-lesions-of-the-triangular-fibrocartilage-as-traumatic-or-degenerative-a-review-of-clinical-accuracy
#16
S Löw, H Erne, T Pillukat, M Mühldorfer-Fodor, F Unglaub, C K Spies
This study examined the reliability of surgeons' estimations as to whether central lesions of the triangular fibrocartilage complex were traumatic or degenerative. A total of 50 consecutive central triangular fibrocartilage complex lesions were independently rated by ten experienced wrist surgeons viewing high-quality arthroscopy videos. The videos were reassessed after intervals of 3 months; at the second assessment surgeons were given the patient's history, radiographs and both, each in a randomized order...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27890247/reproducibility-of-x-rays-and-ct-arthrography-in-slac-snac-scac-wrists
#17
R Belhaouane, N Lebeau, C Maes-Clavier, C Hustin, E Krief, B Bonnaire, M Warin, V Rotari, E David
The purpose of this study was to assess the inter-observer and intra-observer reproducibility of the interpretation of CT arthrography and plain X-rays for scapholunate advanced collapse (SLAC), scaphoid non-union advanced collapse (SNAC) and scaphoid chondrocalcinosis advanced collapse (SCAC) wrist conditions, as well as the clinical relevance of these imaging modalities. The CT and X-rays images were reviewed twice in a blinded and randomized manner by two experienced orthopedic surgeons specialized in hand surgery, two orthopedic surgery residents and two experienced radiologists specialized in bone and joint imaging...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890246/treatment-of-dynamic-scapholunate-instability-dissociation-contribution-of-arthroscopy
#18
C Mathoulin
Scapholunate (SL) ligament injuries generally result from trauma to an extended, supinated wrist, leading to chronic instability that progresses toward osteoarthritis. They can occur together with distal radius fracture. These injuries can be difficult to diagnose, especially early on. Treating chronic SL ligament injuries before the onset of osteoarthritis is still a challenge for surgeons. Until recently, the recommended treatments consisted of open SL ligament reconstruction or repair procedures that reduce pain and improve pinch strength but also lead to wrist stiffness...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890197/-treatment-of-partial-articular-fractures-of-the-distal-radius-in-active-young-adults
#19
C Camps, A Durand, M Merle
The wrist's function is at stake in young active adults with partial intra-articular fractures of the distal radius. The high energy nature of these injuries, displaced fractures with risk of malunion in case of insufficient treatment, and associated ligament or cartilage damage all hinder the prognosis of these fractures. Many classification systems exist to help us analyze and in some cases, select a treatment. Optimal management requires a high-quality preoperative assessment and a precise surgical technique coupled with the use of arthroscopy to deal with joint and ligament injuries in the same operation...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27886828/wrist-arthroscopy-for-athletic-injuries
#20
REVIEW
Rick Tosti, Eon Shin
Management of hand and wrist injuries for athletes often places emphasis on an expeditious return to sport. Arthroscopic techniques have the advantage of directly visualizing joint derangements and correcting them via a minimally invasive approach. This article discusses the evaluation and management of common wrist injuries treated with arthroscopy in athletes, including scapholunate and lunotriquetral injury, triangular fibrocartilage complex tears, hamatolunate impingement, and arthroscopic-assisted reduction of wrist fractures...
February 2017: Hand Clinics
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