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Wrist & Ankle Arthroplasty - Wrist Arthroscopy |
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What is wrist arthroscopy? |
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Arthroscopy is a minimally invasive technique of visualizing the inside of a joint.
The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein"
(to look). The wrist is a complex joint made up of many bones and ligaments, which
hold the bones together (see Figure 1). Wrist arthroscopy allows the surgeon to
diagnose and treat many problems of the wrist through a series of very small incisions
(portals). In the last 5 years, the wrist has become the third most common joint
to undergo arthroscopy, after the knee and shoulder. Because the incisions used
with wrist arthroscopy are smaller and disrupt less soft tissue than conventional
open surgery, pain, swelling and stiffness are minimized and recovery is often faster. |
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When is wrist arthroscopy performed? |
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Wrist arthroscopy allows the visualization of the cartilage surfaces of all bones
in the wrist and better evaluation of the ligaments between the various bones of
the wrist. Frequently after an injury, pain, clicks, and swelling may be indicative
of an internal problem in the wrist. Arthroscopy is often the best way of assessing
the integrity of the ligaments, cartilage, and bone. When wrist problems are encountered,
many are treated through these small incisions using specialized equipment available
for wrist arthroscopy. Often arthroscopy is used to aid in the reduction of fractures
of the bones of the wrist. Wrist arthroscopy is also used to assess the integrity
of the TFCC (triangular fibrocartilage, or meniscus of the wrist). Today, wrist
arthroscopy can even be used to remove some ganglions of the wrist and to assess
the extent and treatment of various types of arthritis of the wrist. |
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How is wrist arthroscopy performed? |
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A small camera fixed to the end of a narrow fiber-optic tube (2.7mm wide) is inserted
through a small incision in the skin (about 5mm long) directly into the back of
the wrist joint (see Figure 2). The camera lens magnifies and projects the small
structures in the wrist onto a television monitor, allowing for more accurate diagnosis.
Several small incisions (portals) are used to allow the surgeon to place the camera
in different positions to see different structures inside the joint as well as to
place various small instruments into the wrist joint to help diagnose and treat
various problems in the wrist (see Figure 3). The wrist is usually distracted and
fluid is infused into the joint to expand the joint and allow improved visualization
during the procedure. Sometimes wrist arthroscopy is combined with open procedures. |
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After wrist arthroscopy |
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After your arthroscopy you will most likely be placed into a wrist splint that allows
full mobility of your fingers. The period of immobilization will vary depending
on what was performed at the time of surgery. Elevating the involved extremity is
important to prevent excessive swelling and pain after your surgery. |
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Risks and limitations of wrist arthroscopy |
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As with any surgery, wrist arthroscopy has risks. These include infection, and potential
damage to nerves and tendons (usually less than 1%). Stiffness might need to be
addressed through post-operative rehabilitation. Wrist arthroscopy is not appropriate
for all wrist conditions and is dependent on the surgeon’s training, expertise and
comfort level. |
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