Wrist Arthroscopy

Wrist-Pain-ArtroscopyWrist arthroscopy requires the use of instruments and materials in dimensions far smaller than those used in larger joints such as the knee and shoulder. Wrist joint arthroscopy has been a breakthrough for the treatment of diseases as well as helping us define, better understand and describe various pathologies.

Wrist injuries involving articular cartilage cause pain, joint locking and reduce mobility and can lead to joint deterioration and osteoarthritis. They can cause primary cartilage injuries  especially in the first row of carpal bones and distal radius but cartilage injuries are much more frequent that occur secondary to fracture of the distal radius. With arthroscopy we can confirm diagnoses, treat the pathology, remove loose bodies.

Using arthroscopic techniques, synovial sampling for biopsies can be performed for the diagnosis of rheumatic diseases as well as for performing synovectomy that involves the removal of the synovium by motorized instruments or radio frequency.

Synovial cysts are small benign tumors of fluid or mucinous content and can be removed by arthroscopic techniques. Treatment of the triangular fibrocartilage. The triangular fibrocartilage is a fibrocartilaginous structure between the ulna and the radius distal articular surface. Injury to this structure causes pain and disability in patients performing activity that requires certain strength in the hands like manual labor or in athletes such as tennis players. Both debridement and repair can be performed with arthroscopy.

Wrist fractures. Arthroscopy can be useful in the treatment of articular fractures of the wrist for control in reducing articular surfaces as well as the treatment of associated cartilage injuries that can occur. The evolution of technology in arthroscopy of the wrist and hand has seen a substantial increase since the 90’s due to the emergence of new instruments designed for this technique, which has transformed what was previously an arthroscopic diagnosis to therapeutic management of intraarticular injuries in both wrist and hand without open surgery. The most common conditions treated via arthroscopy are those of the triangular fibrocartilage, a structure similar to a meniscus, located at the ulnar region of the wrist and that can cause pain and functional deficits in the wrist. Arthroscopy allows us to identify the injury and repair it.

Synovectomies for inflammatory disease, joint stiffness are performed completely or partially associated with open surgery. At present, the reduction of articular fractures of the radius, ulna and even scaphoid are supervised by arthroscopy to improve the final result of the fracture. Another treatment increasing in recent years and aided by the evolution of minimal approaches in orthopedic surgery is endoscopic treatment of the carpal tunnel or arthroscopic cleaning Trapeziometacarpal joint for rizarthrosis.

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