Arthroscopy of the wrist for trauma

Abstract

Over the last decade wrist arthroscopy has proven itself to be a very useful procedure in the management of both bony and soft tissue injuries of the region. Access is achieved through the potential spaces between the dorsal extensor tendons, overlying the joint. Distraction of the wrist joint and instillation of fluid distends the cavity to allow inspection and therapeutic procedures. The radio-carpal and mid-carpal, as well as distal radio-ulna articular surfaces and associated intrinsic and possibly some extrinsic carpal ligaments, are well visualized and dynamic testing of structures is possible. In terms of diagnosis of carpal ligament and triangular fibrocartilage complex (TFCC) injuries it consistently outperforms imaging modalities available. It has also lead to a greater appreciation of the high incidence of occult chondral and ligamentous injury that may co-exist with intraarticular fractures, although the significance of these injuries is debated. Therapeutically it has proven useful in the reconstruction of the articular surface and in the treatment of chondral, intrinsic carpal and TFCC injuries. Results here have been generally comparable to established managements.