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Hand and Wrist Arthroscopy, An Issue of Hand Clinics, E-Book

Hand and Wrist Arthroscopy, An Issue of Hand Clinics, E-Book

Pak-Cheong Ho | Clara Wing-yee Wong

(2017)

Additional Information

Book Details

Abstract

This issue of Hand Clinics, edited by Drs. Clara Wong and Pak-Cheong Ho, will cover Hand and Wrist Arthroscopy. Topics discussed in the volume include, but are not limited to: Diagnostic Wrist Arthroscopy; Arthroscopic Management of Perilunate Injuries; Arthroscopic SL Ligament Reconstruction; Arthroscopic Management of TFCC Foveal Injury; TFCC Repair; Arthroscopy in Kienbock's Disease; Arthroscopic Synovectomy in Rheumatoid Arthritis; Arthroscopic Limited Carpal Fusion; Arthroscopic Management of STTJ Arthritis; Role of Finger Joint Arthroscopy; and Complication of Wrist and Hand Arthroscopy, among others.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Hand and WristArthroscopy\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
Preface: Evolution and Inspiration from Hand and Wrist Arthroscopy vii
Diagnostic Wrist Arthroscopy vii
Wrist Arthroscopy Under Portal Site Local Anesthesia Without Tourniquet and Sedation vii
Chronologic and Geographic Trends of Triangular Fibrocartilage Complex Repair vii
Arthroscopic Management of Triangular Fibrocartilage Complex Peripheral Injury vii
Arthroscopic Management of Triangular Fibrocartilage Complex Foveal Injury viii
Arthroscopic-Assisted Triangular Fibrocartilage Complex Reconstruction viii
Arthroscopic Management of Ulnocarpal Impaction Syndrome and Ulnar Styloid Impaction Syndrome viii
Arthroscopic Evaluation of Associated Soft Tissue Injuries in Distal Radius Fractures viii
Arthroscopic-Assisted Reduction of Intra-articular Distal Radius Fracture viii
Arthroscopic Management of Intra-articular Malunion in Fractures of the Distal Radius ix
Scaphoid Union: The Role of Wrist Arthroscopy ix
Arthroscopic Scapholunate Ligament Reconstruction, Volar and Dorsal Reconstruction ix
Arthroscopic Management of Perilunate Injuries ix
Midcarpal Instability: The Role of Wrist Arthroscopy x
The Role of Wrist Arthroscopy in Kienbock Disease x
Arthroscopic-Assisted Partial Wrist Arthrodesis x
Arthroscopic Transplantation of Osteochondral Autograft for Treatment of Cartilage Defects in the Wrist x
Arthroscopic Management of Dorsal and Volar Wrist Ganglion xi
Arthroscopic Synovectomy of Wrist in Rheumatoid Arthritis xi
Arthroscopic Management of Bennett Fracture xi
Arthroscopic Management of Thumb Carpometacarpal Joint Arthritis xi
Arthroscopic Management of Scaphoid-Trapezium-Trapezoid Joint Arthritis xi
Progress and Role of Finger Joint Arthroscopy xii
Complications of Wrist and Hand Arthroscopy xii
HAND CLINICS\r xiii
FORTHCOMING ISSUES xiii
February 2018 xiii
May 2018 xiii
August 2018 xiii
RECENT ISSUES xiii
August 2017 xiii
May 2017 xiii
February 2017 xiii
Preface:\rEvolution and Inspiration from Hand and Wrist Arthroscopy xv
Diagnostic Wrist Arthroscopy 571
Key points 571
INTRODUCTION 571
CLINICALLY RELEVANT ANATOMY 572
WRIST ARTHROSCOPY TECHNIQUE 572
DORSAL PORTALS: 3-4 PORTAL 572
4-5, 6U, AND 6R PORTALS 573
SYSTEMATIC DORSAL RADIOCARPAL EVALUATION 573
MIDCARPAL EVALUATION 573
ADVANCED ARTHROSCOPIC TECHNIQUES 577
Volar Radial, Ulnar, and Midcarpal Portals 577
Distal Radioulnar Joint Arthroscopy 578
SUMMARY 583
ACKNOWLEDGMENTS 583
REFERENCES 583
Wrist Arthroscopy Under Portal Site Local Anesthesia Without Tourniquet and Sedation 585
Key points 585
INTRODUCTION 585
INDICATIONS AND CONTRAINDICATIONS 585
TECHNIQUE OF WRIST ARTHROSCOPY UNDER PORTAL SITE LOCAL ANESTHESIA 586
TECHNICAL TIPS 588
ADVANTAGES OF PORTAL SITE LOCAL ANESTHESIA 589
PAIN CONTROL EFFICIENCY AND CLINICAL OUTCOME 589
POTENTIAL RISKS 590
SUMMARY 590
REFERENCES 591
Chronologic and Geographic Trends of Triangular Fibrocartilage Complex Repair 593
Key points 593
INTRODUCTION 593
CLASSIFICATION 594
LITERATURE REVIEW 595
REPAIR OF THE ULNAR SIDE (PALMER 1B) 595
Trends in Chronologic Order 595
Trends by Geographic Area 599
REPAIR ON RADIAL SIDE (PALMER 1D) 601
Trends in Chronologic Order 601
Trends by Geographic Area 602
REPAIR IN OTHER AREAS 603
SUMMARY 603
REFERENCES 603
Arthroscopic Management of Triangular Fibrocartilage Complex Peripheral Injury 607
Key points 607
INTRODUCTION 607
CLASSIFICATION OF PALMER TYPE I-B TRIANGULAR FIBROCARTILAGE COMPLEX INJURIES 608
SYMPTOMS AND FINDINGS 608
SURGICAL TECHNIQUES 609
ARTHROSCOPIC REPAIR 610
POSTOPERATIVE CARE 614
COMPLICATIONS AND MANAGEMENT 616
OUTCOMES 616
SUMMARY 617
REFERENCES 617
Arthroscopic Management of Triangular Fibrocartilage Complex Foveal Injury 619
Key points 619
INTRODUCTION: NATURE OF THE PROBLEM 619
INDICATIONS 619
CONTRAINDICATIONS 619
SURGICAL TECHNIQUE/PROCEDURE 620
Preoperative Planning 620
Preparation and Patient Positioning 620
SURGICAL APPROACH 620
Diagnosis from Radiocarpal Joint and Distal Radioulnar Joint 620
Trampoline test, hook test, and floating sign from radiocarpal joint 620
Foveal Debridement 621
Inside-Out Technique 621
COMPLICATIONS 622
POSTOPERATIVE CARE 622
OUTCOMES 623
SUMMARY 623
REFERENCES 623
Arthroscopic-Assisted Triangular Fibrocartilage Complex Reconstruction 625
Key points 625
RELEVANT ANATOMY AND BIOMECHANICS OF THE TRIANGULAR FIBROCARTILAGE COMPLEX 625
EPIDEMIOLOGY AND PATHOMECHANISM OF TRIANGULAR FIBROCARTILAGE COMPLEX INJURY 626
CLINICAL ASSESSMENT OF TRIANGULAR FIBROCARTILAGE COMPLEX TEAR 626
MANAGEMENT AND INDICATION OF TRIANGULAR FIBROCARTILAGE COMPLEX RECONSTRUCTION 627
TRIANGULAR FIBROCARTILAGE COMPLEX RECONSTRUCTION 627
SURGICAL TECHNIQUE 627
Setup and Instruments 627
Step 1: wrist arthroscopy and triangular fibrocartilage complex central opening preparation 628
Step 2: harvesting tendon graft 628
Step 3: radial tunnel preparation with passage of tendon graft 628
Step 4: ulnar tunnel preparation 629
Step 5: passing of the volar limb of tendon graft into joint and exteriorization through ulnar tunnel 629
Step 6: passing of the dorsal limb of tendon graft into joint and exteriorization through ulnar tunnel 629
Step 7: tensioning and tying around ulnar neck 630
REHABILITATION 631
OUTCOMES AND COMPLICATIONS 632
SUMMARY 636
REFERENCES 636
Arthroscopic Management of Ulnocarpal Impaction Syndrome and Ulnar Styloid Impaction Syndrome 639
Key points 639
ULNOCARPAL IMPACTION SYNDROME 639
Relevant Anatomy and Biomechanics 639
Classification 641
Diagnosis 641
ARTHROSCOPIC WAFER RESECTION 641
Indications 641
Contraindications 642
Surgical technique: arthroscopic wafer resection 642
Alternative procedures: arthroscopic distal metaphyseal ulnar shortening osteotomy 642
Outcomes 643
ULNAR STYLOID IMPACTION SYNDROME 644
Relevant Anatomy and Etiologic Factors 644
Diagnosis 645
Treatment 645
Arthroscopic-Assisted Ulnar Styloid Excision Technique 645
Outcomes 645
Ulnar Styloid Nonunions 647
REFERENCES 649
Arthroscopic Evaluation of Associated Soft Tissue Injuries in Distal Radius Fractures 651
Key points 651
INTRODUCTION 651
INDICATIONS FOR ARTHROSCOPY IN DISTAL RADIUS FRACTURES 652
THE ARTHROSCOPIC PROCEDURE: DRY OR WET? 653
THE ARTHROSCOPIC PROCEDURE: ARTHROSCOPIC EVALUATION 653
TRIANGULAR FIBROCARTILAGE COMPLEX INJURIES 653
INTERCARPAL LIGAMENT INJURIES 653
SCAPHOLUNATE LIGAMENT INJURIES 655
Grade I to III Scapholunate Injuries 655
Grade IV Scapholunate Injuries 656
LUNOTRIQUETRAL LIGAMENT INJURIES 656
CHONDRAL LESIONS 656
OUTCOMES 657
SUMMARY 657
REFERENCES 657
Arthroscopic-Assisted Reduction of Intra-articular Distal Radius Fracture 659
Key points 659
INTRODUCTION 659
INDICATIONS/CONTRAINDICATIONS 660
SURGICAL TECHNIQUE 660
Preoperative Planning 660
Preparation and Patient Positioning 660
Surgical Approach 660
Exposure 660
Fracture reduction 661
Wrist arthroscopic inspection 662
Postoperative Care 663
Complications 664
The Advantages of Wrist Arthroscopy 664
Outcomes 666
REFERENCES 667
Arthroscopic Management of Intra-articular Malunion in Fractures of the Distal Radius 669
Key points 669
INTRODUCTION 669
INDICATIONS AND CONTRAINDICATIONS 670
TECHNIQUE 671
ARTHROSCOPIC RESECTION ARTHROPLASTY 673
PROCEDURE 674
DISCUSSION 674
REFERENCES 675
Scaphoid Union 677
Key points 677
RATIONALE 677
SURGICAL TECHNIQUE 678
Case Studies 678
Case 1 678
Arthroscopic Scapholunate Ligament Reconstruction, Volar and Dorsal Reconstruction 687
Key points 687
INTRODUCTION: NATURE OF THE PROBLEM 687
ANATOMIC RECONSTRUCTION 688
AVOIDANCE OF OPEN SURGERY AND DETACHMENT OF THE JOINT CAPSULE 688
RELIABLE AND STURDY RECONSTRUCTION FOR EARLY MOBILIZATION 689
INDICATIONS AND CONTRAINDICATIONS 689
SURGICAL TECHNIQUE AND PROCEDURE 690
Preoperative Planning 690
Preparation and Patient Positioning 690
Surgical Approach 690
Surgical Procedure 690
Step 1: Bone tunnels 690
Step 2: Preparation to retrieve the graft 692
Step 3: Harvesting the flexor carpi radialis tendon graft 693
Step 4: Graft passage and fixation 694
Step 5: Volar reconstruction 695
Graft reinforcement 696
COMPLICATIONS AND THEIR MANAGEMENT 696
Tunnel Breakage and Fracture 697
Damage of Delicate Structures Around the Portals or Tunnels 697
Avascular Necrosis of Scaphoid or Lunate 698
Postoperative Care 698
OUTCOMES 700
SUMMARY 703
SUPPLEMENTARY DATA 706
REFERENCES 706
Arthroscopic Management of Perilunate Injuries 709
Key points 709
PATIENTS 709
SURGICAL TECHNIQUE 710
Reduction of the Capitolunate Dislocation 710
Reduction and Fixation for Perilunate Dislocations 710
Reduction and Fixation for Trans-scaphoid Perilunate Fracture Dislocations 712
POSTOPERATIVE MANAGEMENT 712
RESULTS 712
SUMMARY 714
REFERENCES 714
Midcarpal Instability 717
Key points 717
INTRODUCTION 717
TYPES OF MIDCARPAL INSTABILITY 718
Palmar 718
Types 1 and 2 (ulnar) 718
Types 3 and 4 (radial) 718
Dorsal 718
Combined 718
GRADING OF PALMAR MIDCARPAL INSTABILITY 718
ASSESSMENT 719
History 719
Examination 719
Anterior midcarpal drawer test 719
Midcarpal shift test 719
Dorsal midcarpal tests 719
Imaging 720
Radiographs 720
Computed tomography 720
MRI 720
Diagnostic Arthroscopy 720
TREATMENT 720
Conservative 720
Soft Tissue Reconstruction 720
Bone Fusions 721
Arthroscopy 721
Arthroscopic Thermal Capsular Shrinkage 721
COMPLICATIONS OF ARTHROSCOPIC CAPSULAR SHRINKAGE 722
Recent Example Case 724
SUMMARY 724
ACKNOWLEDGMENTS 725
REFERENCES 725
The Role of Wrist Arthroscopy in Kienbock Disease 727
Key points 727
INTRODUCTION 727
WRIST PATHOANATOMY IN KIENBOCK DISEASE 727
WRIST ARTHROSCOPY IN KIENBOCK DISEASE 728
BAIN AND BEGG CLASSIFICATION 728
LICHTMAN AND BAIN CLASSIFICATION 729
ARTHROSCOPIC SURGERY IN KIENBOCK DISEASE 730
Arthroscopic Forage 730
Arthroscopic Radioscapholunate Fusion 730
Arthroscopic Scaphocapitate Fusion 730
POSTOPERATIVE MANAGEMENT: ARTHROSCOPIC PARTIAL CARPAL FUSIONS 732
Arthroscopic Proximal Row Carpectomy 732
Postoperative Management of Proximal Row Carpectomy 732
SUMMARY 733
REFERENCES 733
Arthroscopic-Assisted Partial Wrist Arthrodesis 735
Key points 735
INTRODUCTION/NATURE OF PROBLEM 735
WHY DO IT AS AN ARTHROSCOPIC PROCEDURE: INDICATIONS AND CONSIDERATIONS 737
My Personal Thoughts 737
INDICATIONS/CONTRAINDICATIONS FOR PARTIAL WRIST ARTHRODESIS 737
SURGICAL TECHNIQUE/PROCEDURE 738
Preoperative Planning 738
Preparation of the Operation Room, Patient Positioning, and Surgical Approach 739
Setup and Instrumentation 739
Instruments 739
Arthroscopic Diagnostic View 739
Surgical Procedure in Scapholunate Advanced Collapse or Scaphoid Nonunion Advanced Collapse: 4-Corner Fusion 740
Step 1: arthroscopic cleaning, synovectomy, and debridement 740
Step 2: midcarpal arthroscopic resection of arthritic joint surfaces 740
Step 3: resection (of part) of the scaphoid in a miniopen approach 741
Step 4: correction of dorsal intercalated segment instability or other deformities or malalignments 741
Step 5: temporary osteosynthesis after aligning the carpal bones under image intensifier 741
Step 6: arthroscopic bone graft 742
Step 7: final osteosynthesis 742
Step 8: wound closure 743
Postoperative Treatment 743
OTHER ARTHROSCOPIC PARTIAL WRIST ARTHRODESIS 744
Scaphoid-Trapezium-Trapezoid Arthrodesis 744
Indications 744
Scaphoid-Capitate/Scaphoid-Capitate-Lunate Arthrodesis 745
Arthroscopic Transplantation of Osteochondral Autograft for Treatment of Cartilage Defects in the Wrist 755
Key points 755
INTRODUCTION 755
PATIENT SERIES 756
SURGICAL TECHNIQUE 756
RESULT 759
CASE REPORT 1 759
CASE REPORT 2 760
DISCUSSION 762
SUMMARY 766
REFERENCES 766
Arthroscopic Management of Dorsal and Volar Wrist Ganglion 769
Key points 769
INTRODUCTION: NATURE OF THE PROBLEM 769
INDICATIONS/CONTRAINDICATIONS 770
SURGICAL TECHNIQUE/PROCEDURE 770
Preoperative Planning 770
Preparation and Patient Positioning 771
Dorsal wrist ganglion 771
Surgical approach 771
Surgical procedure 771
Step 1: resection of the dorsal mucoid dysplasia at the midcarpal interval through a transcystic approach 771
Step 2: resection of the ganglion wall 771
Step 3: treating the scapholunate instability or dorsal capsuloscapholunate septum lesion if any 771
Step 4: wound closure and postoperative care 772
Volar wrist ganglion 772
Surgical approach 772
Surgical procedure 772
Step 1: location of the ganglion 772
Step 2: ganglion resection 772
Step 3: closing and postoperative care 772
COMPLICATIONS AND MANAGEMENT 773
POSTOPERATIVE CARE 773
OUTCOMES 773
Recurrence 773
Objective and Subjective Clinical Results 773
Pain 773
Postoperative range of motion and strength 774
Functional scores and patient satisfaction 774
Return to work and daily activity 774
Comparison Between Open Surgery and Arthroscopic Removal of Wrist Ganglia 774
Indications 774
Recurrence and complications 775
Aesthetics 776
SUMMARY 776
REFERENCES 776
Arthroscopic Synovectomy of Wrist in Rheumatoid Arthritis 779
Key points 779
INTRODUCTION 779
DIAGNOSIS AND CLASSIFICATION 779
TREATMENT 780
SYNOVECTOMY 780
ARTHROSCOPIC SYNOVECTOMY 781
The Timing and Indication of Arthroscopic Synovectomy 781
Other Indications of Arthroscopic Synovectomy 781
SURGICAL TECHNIQUE OF ARTHROSCOPIC SYNOVECTOMY 781
RESULTS 782
SUMMARY 784
REFERENCES 784
Arthroscopic Management of Bennett Fracture 787
Key points 787
INTRODUCTION 787
INDICATIONS 788
CONTRAINDICATIONS 788
SURGICAL TECHNIQUE 788
Preoperative Planning 788
Preparation and Patient Positioning 790
Surgical Approach 790
COMPLICATIONS 791
REHABILITATION 792
OUTCOMES 793
SUMMARY 793
REFERENCES 793
Arthroscopic Management of Thumb Carpometacarpal Joint Arthritis 795
Key points 795
INTRODUCTION/NATURE OF THE PROBLEM 795
Thumb Carpometacarpal Joint Is Born to Have Good Freedom of Motion 795
Good Mobility at the Thumb Carpometacarpal Joint Predisposes Attenuation of Capsuloligamentous Structures, Joint Incongruit ... 796
Prevalence of Radiographic and Symptomatic Thumb Carpometacarpal Joint Osteoarthiritis 796
Why Is Thumb Carpometacarpal Joint Osteoarthritis Painful? 796
Operation Decision 797
Options of Surgical Intervention for Established Thumb Carpometacarpal Joint Osteoarthritis 797
Is There Any Procedure That Is Simpler, Less Invasive, and More Effective to Relieve Patients’ Pain and Meet Their Demands? 798
ARTHROSCOPIC DEBRIDEMENT, SYNOVECTOMY, WITH MINIMAL BONE WORK 798
Patient Series 798
Surgical Techniques 798
Results 801
Subjective exertion pain 801
Thumb mobility 801
Palmar abduction range 801
Strength 802
Satisfaction and complications 802
Correlation of pain symptoms 802
Analysis of the trends for 2 years more 802
Discussion 802
ARTHROSCOPIC PARTIAL TRAPEZIECTOMY + SUTURE BUTTON SUSPENSIONPLASTY 803
Surgical Technique 804
Case Example 804
Results and Discussion 805
Unsatisfactory results 805
Fair results 805
Fair results 806
ARTHROSCOPIC THUMB CARPOMETACARPAL JOINT EXCISION + SUTURE BUTTON SUSPENSIONPLASTY + K-WIRE FIXATION 808
Surgical Technique 808
Case Example 808
Results and Discussion 809
SUMMARY 809
SUPPLEMENTARY DATA 810
REFERENCES 810
Arthroscopic Management of Scaphoid-Trapezium-Trapezoid Joint Arthritis 813
Key points 813
INTRODUCTION 813
SCAPHOID-TRAPEZIUM-TRAPEZOID ARTHROSCOPY FOR ARTHRITIS 813
Anatomy and Pathogenesis of Scaphoid-Trapezium-Trapezoid Arthritis 813
Classification and Traditional Treatment Options 814
Indications and Contraindications for Scaphoid-Trapezium-Trapezoid Arthroscopy 814
Surgical Procedure 815
Postoperative Protocol 815
RESULTS 816
SUMMARY 816
ACKNOWLEDGMENTS 817
REFERENCES 817
Progress and Role of Finger Joint Arthroscopy 819
Key points 819
INTRODUCTION 819
INSTRUMENTS 819
Small Joint Arthroscope 819
Shaver System 820
Grasping Forceps 820
Radiofrequency Probes 820
Traction Apparatus 820
Fluid Management System 820
GENERAL TECHNIQUE 820
Anesthesia 820
Portals 820
Standard Surgical Procedure 821
Authors’ Preferred Methods 822
INDICATIONS AND DETAILS FOR EACH CLINICAL CONDITION 823
Metacarpophalangeal Joint Arthroscopy 823
Inflammatory arthritis 823
Pyogenic arthritis 823
Degenerative arthritis 823
Intra-articular fractures 823
Removal of loose bodies 824
Collateral ligament injury 824
Chronic pain and instability 824
Stiff fingers 824
Proximal Interphalangeal Joint Arthroscopy 824
Inflammatory arthritis 824
Pyogenic arthritis 824
Removal of foreign bodies 824
Distal Interphalangeal Joint Arthroscopy 825
Arthritis 825
Arthrodesis 825
POSSIBLE COMPLICATIONS 825
Articular Cartilage Damage 825
Tendon Injuries 825
Neurovascular Bundle Injuries 825
ROLE OF FINGER JOINT ARTHROSCOPY 825
Arthritis 826
Rheumatoid arthritis 826
Degenerative arthritis 827
Pyogenic arthritis 827
Intra-articular Fractures 827
Collateral Ligament Injury 827
Removal of Loose Bodies or Foreign Bodies 828
Chondral Lesions 828
Arthrodesis 828
Chronic Pain and Instability 828
Stiff Fingers 828
REFERENCES 828
Complications of Wrist and Hand Arthroscopy 831
Key points 831
INTRODUCTION 831
Cadaveric Studies 832
Clinical Studies 834
SUMMARY 837
REFERENCES 837