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Wrist arthroscopy

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https://www.readbyqxmd.com/read/28259281/diagnosis-and-arthroscopic-management-of-dorsal-wrist-capsular-impingement
#1
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
#2
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
#3
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...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28119801/the-parc-lesion-a-proximal-avulsion-of-the-radiocarpal-capsule
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27856161/safety-of-dorsal-wrist-arthroscopy-portals-a-magnetic-resonance-study
#12
Umile Giuseppe Longo, Mattia Loppini, Riccardo Del Vescovo, Luigi Cazzato, Bruno Beomonte Zobel, Nicola Maffulli, Vincenzo Denaro
In wrist arthroscopy, the standard dorsal portals are the most commonly used. However, their placement can be associated with injuries to the neurovascular structures of the radiocarpal joint. The present study assessed and compared the distance of commonly used dorsal portals to radial and ulnar neurovascular structures. Forty patients (20 males, 20 females) were evaluated with T1-weighted spin-echo (SE) magnetic resonance (MR) sequences. We measured the distance between 1-2 and 3-4 portals and radial vascular bundle and the nearest branch of the superficial branch of radial nerve (SBRN)...
November 14, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27786419/medical-arthroscopy-a-tool-for-diagnosis-and-research-in-rheumatology
#13
REVIEW
Ved Chaturvedi, Molly Mary Thabah, Vinod Ravindran, Patrick D W Kiely
Arthroscopy is an important diagnostic procedure which can be used in rheumatology practice to provide direct visualization of the joint cavity, permitting macroscopic evaluation of the synovium, sampling for histopathologic and microbiologic examination and the potential therapeutic benefit of lavage. The term 'medical arthroscopy' is used here to refer to arthroscopy performed by rheumatologists for these purposes. This term differentiates arthroscopy performed by orthopedic surgeons for structural interventions such as meniscal debridement and ligament repair...
October 27, 2016: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/27777825/complications-of-wrist-arthroscopy-a-multicenter-study-based-on-10-107-arthroscopies
#14
Caroline Leclercq, Christophe Mathoulin
Background Wrist arthroscopy is now a routine procedure, regarded as safe. Complications are reported in the literature as being rare and mostly minor. Purpose The two goals of this study were to evaluate the incidence and nature of complications based on a very large multicenter retrospective study, and to investigate about a potential learning curve. Methods The authors sent a detailed questionnaire to all members of the European Wrist Arthroscopy Society (EWAS), inquiring about the number and types of complications encountered during their practice of wrist arthroscopy, and about their experience with the technique...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777824/the-course-of-the-terminal-posterior-interosseous-nerve-and-its-relationship-with-wrist-arthroscopy-portals
#15
Yongwei Pan, Leung-Kim Hung
Purpose The terminal branches of the posterior interosseous nerve (PIN) are the main articular branch on the dorsal aspect of the wrist. Its relationship to dorsal wrist arthroscopic portals has not yet been elucidated. The purpose of this study was to quantitatively describe the anatomical relationships between the dorsal wrist arthroscopic portals and the PIN. Methods Dorsal wrist arthroscopic portals were established in 28 cadaver extremities, after which the limbs were dissected. Measurements were taken from the portals to the PIN...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777822/the-role-of-dynamic-4d-ct-in-the-detection-of-scapholunate-ligament-injury
#16
Sanjeev Kakar, Ryan E Breighner, Shuai Leng, Cynthia H McCollough, Steven L Moran, Richard A Berger, Kristin D Zhao
Background Scapholunate (SL) interosseus ligament injuries detected at an early stage could allow the surgeon to prevent progression through the spectrum of injury that leads to instability, and eventually osteoarthritis. We contend that early instability following injury can be detected by visualizing the relative motions and distances between the involved carpal bones (scaphoid and lunate) during wrist movement in vivo. The purpose of this study is to demonstrate the utility of dynamic CT (i.e., 4DCT) in diagnosing SL interosseus ligament injuries in two patients with clinical suspicion of SL interosseus ligament injury during flexion-extension (FE), radial-ulnar (RU) deviation, and dart thrower's (DT) motions...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777814/kienb%C3%A3-ck-disease-and-arthroscopy-assessment-classification-and-treatment
#17
Gregory I Bain, Simon B M MacLean, Wing-Lim Tse, Pak-Cheong Ho, David M Lichtman
The assessment and management of Kienböck Disease (KD) has always been a conundrum. The Lichtman classification has traditionally been used to guide treatment based on imaging. Arthroscopy provides a direct visualization of the articular surface, allows probing of the surfaces, and enables minimally invasive techniques to be performed. The Lichtman-Bain classification is a new classification that takes into account the osseous, vascular, and cartilage aspects of the lunate and the secondary effects on the wrist...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27751844/how-well-can-step-off-and-gap-distances-be-reduced-when-treating-intra-articular-distal-radius-fractures-with-fragment-specific-fixation-when-using-fluoroscopy
#18
M Thiart, A Ikram, R P Lamberts
INTRODUCTION: Although fragment specific fixation has proved to be an effective treatment regime, it has not been established how successfully this treatment could be performed using fluoroscopy and what the added value of arthroscopy could be. Establish gap and step-off distances after in intra-articular distal radius fractures that have been treated with fragment specific fixation while using fluoroscopy. MATERIAL: Forty-four patients with an intra-articular distal radius fracture were treated with fragment specific fixation while using fluoroscopy...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27740464/inside-out-method-to-develop-volar-arthroscopic-portals-of-the-wrist-in-cadaver-specimens
#19
I Naroura, A Zemirline, C Taleb, F Lebailly, S Facca, J J Hidalgo Díaz, S Collon, P Liverneaux
Three direct volar portals for wrist arthroscopy have been described previously: two radiocarpal and one midcarpal. The aim of this study was to systematically describe four volar arthroscopic portals through minimally invasive incisions using an inside-out approach from known dorsal portals. Four volar arthroscopic wrist portals were studied on six hand specimens using an inside-out technique: a radial radiocarpal approach (RRCA), an ulnar radiocarpal approach (URCA), a radial midcarpal approach (RMCA) and an ulnar midcarpal approach (UMCA)...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27703801/trans-4-portal-as-a-new-portal-for-accessing-the-lunate-in-wrist-arthroscopy-a-cadaveric-study
#20
Reza Shahryar-Kamrani, Hossein Saremi, Leila Oryadi-Zanjani, Mohammad Hossein Nabian, Azita Amoozadeh, Amir Hossein Moradi
BACKGROUND: Evolving wrist arthroscopy requires creating new portals, and creating portals reciprocally leads to increased indications for arthroscopic wrist procedures. To facilitate access to the lunate bone and fossa for new arthroscopic procedures, a new portal was used. This is a cadaveric study of this portal. OBJECTIVES: In this cadaveric study, we evaluated a portal in wrist arthroscopy for procedures involving the lunate bone and lunate fossa. MATERIALS AND METHODS: Seventeen wrists from 10 fresh cadavers were included in this study...
July 2016: Iranian Red Crescent Medical Journal
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