Wrist arthroscopy techniques

✍ Scribed by Christophe Mathoulin

• Year: 2019
• Tongue: English
• Leaves: 203
• Edition: 2
• Category: Library

✦ Table of Contents

Wrist Arthroscopy Techniques 2nd Edition
Title Page
Copyright
Contents
Videos
Foreword
Preface
Acknowledgments
Contributors
1 Materials and Set-Up
1.1 Introduction
1.2 Materials
1.2.1 Arthroscopy Column
1.2.2 Arthroscope
1.2.3 Instruments
1.2.4 Traction
1.2.5 Irrigation
1.3 Set-Up
1.4 Conclusion
Reference
2 Surgical Approaches
2.1 Introduction
2.2 General Principles of Approaches
2.3 Radiocarpal Portals
2.3.1 3?4 Radiocarpal Portal
2.3.2 6R Radiocarpal Portal
2.3.3 4?5 Radiocapral Portal
2.3.4 6U Radiocarpal Portal
2.3.5 1?2 Radiocarpal Portal
2.4 Midcarpal Portals
2.4.1 Midcarpal Ulnar Portal
2.4.2 Radial Midcarpal Portal
2.4.3 STT Midcarpal Portal
2.5 Distal Radioulnar Portals
2.5.1 Distal Radioulnar Portal
2.5.2 Direct Foveal Portal
2.5.3 Proximal
Distal Radioulnar? Portal
2.6 Trapeziometacarpal Portal
2.6.1 Palmar 1 Portal
2.6.2 Dorsal 1 Portal
2.7 Palmar Portals
2.7.1 Radial Palmar Radiocarpal Portal
2.7.2 Ulnar Palmar Radiocarpal Portal
2.7.3 Palmar Midcarpal Portal
2.8 Conclusion
Reference
3 Arthroscopic Anatomy of theWrist
3.1 Introduction
3.2 Principles of Exploration
3.3 Radiocarpal Exploration
3.4 Midcarpal Assessment
3.5 Conclusion
4 Arthroscopic Treatment of DorsalWrist Ganglia
4.1 Introduction
4.2 Ligament Anatomy of the Dorsal Scapholunate Region
4.3 Operative Technique
4.3.1 Patient Preparation
4.3.2 Assessment of the Size and Position of the Ganglion
4.3.3 Exploration of the Midcarpal Joint
4.3.4 Resection of the Dorsal Mucoid Dysplasia at the Midcarpal Interval through a Transcystic Approach
4.3.5 Resection of the Ganglion Wall
4.3.6 Closing and Postoperative Care
4.4 Conclusion
References
5 Arthroscopic DorsalWrist Ganglion Excision with Colored Dye-Aided Stalk Resection
5.1 Introduction
5.2 Operative Technique
5.2.1 Patient Preparation and Positioning
5.2.2 Surgical Steps
5.2.3 Closure and Postoperative Care
5.3 Conclusion
References
6 Arthroscopic Excision of VolarWrist Ganglia
6.1 Introduction
6.2 Operative Technique
6.2.1 Patient Preparation and Positioning
6.2.2 First Surgical Phase: Intra-articular Assessment
6.2.3 Second Surgical Phase: Identification and Resection of the Ganglion
6.2.4 Closure and Postoperative Care
6.3 Conclusion
7 Arthroscopic Radial Styloidectomy
7.1 Introduction
7.2 Operative Technique
7.2.1 Patient Preparation
7.2.2 Exploration of the Radiocarpal Joint
7.2.3 Styloidectomy through the 1?2 Radiocarpal Portal
7.2.4 Styloidectomy through the 3?4 Portal
7.2.5 Styloidectomy through a Palmar Approach
7.2.6 Closure and Postoperative Care
7.3 Conclusion
Reference
8 Anatomy of the TFCC: Current Concepts
8.1 Introduction
8.2 Histology
8.3 Anatomy
8.4 Biomechanics
8.5 Arthroscopic Examination of TFCC Tears or Injuries
8.6 Conclusion
References
9 Arthroscopic Repair of Peripheral Tears of the TFCC
9.1 Introduction
9.2 Operative Technique
9.2.1 Patient Preparation and Set-Up
9.2.2 Exploration
9.2.3 Creation of a DRUJ Portal
9.2.4 Performing the Suture
9.2.5 Securing the Final Suture
9.2.6 Postoperative Care
9.3 Conclusion
References
10 "Double Loop? Suture Repair in Large Dorsal Tears of the TFCC
10.1 Introduction
10.2 Operative Technique
10.2.1 Patient Preparation
10.2.2 Exploration
10.2.3 TFCC Repair
10.2.4 Postoperative Care
10.3 Conclusion
11 Arthroscopy-Assisted Foveal Reinsertion of the TFCC with an Anchor
11.1 Introduction
11.2 Operative Technique
11.2.1 Patient Preparation
11.2.2 Exploration
11.2.3 Extending the Medial Incision
11.2.4 Exploration and Debridement of the Distal Radioulnar Joint
11.2.5 Insertion of the Anchor
11.2.6 TFCC Suture
11.2.7 Postoperative Care
11.3 Conclusion
References
12 Arthroscopic-Assisted Foveal Reinsertion of the TFCC
12.1 Introduction
12.2 Operative Technique
12.2.1 Patient Preparation
12.2.2 Exploration
12.2.3 Arthroscopic-Assisted Foveal Refixation of the TFCC
12.2.4 Postoperative Care
12.3 Conclusion
13 Arthroscopic Reconstruction of the TFCC Using a Free Tendon Graft
13.1 Introduction
13.2 Operative Technique
13.2.1 Patient Preparation
13.2.2 Harvesting the Tendon Graft
13.2.3 Making the Radial Tunnel and Passing the Tendon through
13.2.4 Preparation of the Graft Area in the TFCC
13.2.5 Creating the Ulnar Tunnel
13.2.6 Passing the Graft through the Ulnar Tunnel
13.2.7 Passage and Fixation of the Graft
13.2.8 Closure and Postoperative Care
13.3 Conclusion
References
14 Arthroscopic Distal Ulnar Resection
14.1 Introduction
14.2 Operative Technique
14.2.1 Patient Preparation and Positioning
14.2.2 Exploration and Synovectomy of the Radiocarpal Joint
14.2.3 Preparation of TFCC Ligament
14.2.4 Distal Ulnar Resection
14.2.5 Ulnar Head Resection when the TFCC Is Intact
14.2.6 Closure and Postoperative Care
14.3 Conclusion
15 Arthroscopic Hamatum Head Resection for HALT Syndrome
15.1 Introduction
15.2 Operative Technique
15.2.1 Patient Preparation and Positioning
15.2.2 Exploration of the Bones
15.2.3 Resection of the Tip of the Hamate
15.2.4 Closure and Postoperative Care
15.3 Conclusion
16 Anatomy of the Scapholunate Complex
16.1 Introduction
16.2 Applied Anatomy and Biomechanics of the Carpal Ligaments
16.2.1 Intrinsic Ligament: Scapholunate Interosseous Ligament
16.2.2 Extrinsic Ligaments
16.3 Arthroscopic Testing of Scapholunate Stability桸ew Classification System
16.3.1 Arthroscopic Testing of Predynamic Instability
16.3.2 EWAS Classification for Scapholunate Instability
16.4 Arthroscopic Testing of Extrinsic Ligaments桰njury Classification
16.4.1 Classification for Extrinsic Ligament Injury
16.4.2 Method for Arthroscopic Testing of Extrinsic Ligaments
16.5 Conclusion
References
17 Dorsal Capsuloligamentous Repair of the Scapholunate Ligament Tear
17.1 Introduction
17.2 Operative Technique
17.2.1 Patient Preparation and Positioning
17.2.2 Radiocarpal Exploration
17.2.3 Exploration of the Midcarpal Joint
17.2.4 Performing the Dorsal Capsuloligamentous Suture
17.2.5 Tying the First Knot
17.2.6 K-Wire Fixation of the SL Joint (Optional)
17.2.7 Tying the Second (Last) Knot
17.2.8 Large SL Ligament Tear with Instability (EWAS 4)
17.2.9 Large SL Ligament Detachment without Ligament Stump on the Scaphoid
17.2.10 Postoperative Care
17.3 Conclusion
References
18 Arthroscopic-Assisted Box Reconstruction of Scapholunate Ligament with Tendon Graft
18.1 Introduction
18.2 Operative Techniques
18.2.1 Patient Preparation and Positioning
18.2.2 Exploration of Radiocarpal Joint and Midcarpal Joint
18.2.3 Preparation of Dorsal and Volar TunnelWound
18.2.4 Correction of the DISI Deformity and Stabilization of Scaphoid and Lunate Position
18.2.5 Preparation of Lunate Bone Tunnel
18.2.6 Preparation of Scaphoid Bone Tunnel
18.2.7 Passing the PL Tendon Graft through the Scaphoid and Lunate Bone Tunnel
18.2.8 Assessment through Midcarpal Joint Arthroscopy and Scapholunate Interval Reduction with PL Tendon Graft
18.3 Closure and Postoperative Care
18.4 Conclusion
References
19 Arthroscopic-Assisted Reconstruction of LT-Ligament
19.1 Introduction
19.2 Operative Technique
19.2.1 Patient Preparation and Positioning
19.2.2 Exploration of the Ligament and the Bone
19.2.3 Preparation of the Tendon Slip and the Bones
19.2.4 Passing the Tendon Slip through and Securing the Graft in the Bones
19.3 Closure and Postoperative Care
19.4 Conclusion
References
20 Arthroscopic-Assisted Fixation of Trans-Scaphoid Perilunate Dislocation
20.1 Introduction
20.2 Operative Technique
20.2.1 Patient Preparation and Positioning
20.2.2 Radiocarpal Arthroscopy and Synovectomy
20.2.3 Midcarpal Arthroscopy and Exploration
20.2.4 Dissection of the Volar Capsule
20.2.5 Assessment of Intercarpal Ligaments Stability
20.2.6 Screw Fixation of Scaphoid
20.2.7 K-Wire Fixation of Lunotriquetral Joint
20.2.8 Assessment of Stability after Fixation
20.2.9 Closure and Postoperative Care
20.3 Conclusion
References
21 Volar Capsuloligamentous Suture as Treatment of Volar Midcarpal Instability
21.1 Introduction
21.2 Operative Technique
21.2.1 Patient Preparation and Positioning
21.2.2 First Phase: Arthroscopic Exploration
21.2.3 Second Phase: Volar Ulnar Approach
21.2.4 Third Phase: Volar CapsuleLigament Suturing
21.2.5 Postoperative Care
21.3 Conclusion
References
22 Arthroscopic-Assisted Fixation of Intra-Articular Distal Radius Fractures
22.1 Introduction
22.2 Operative Technique (J. M. Cogent)
22.2.1 Patient Preparation and Positioning
22.2.2 First Surgical Phase: Provisional Fixation
22.2.3 Second Surgical Phase: Arthroscopic Evaluation
22.2.4 Third Surgical Phase: Final Fixation
22.2.5 Postoperative Care
22.3 Conclusion
Reference
23 Arthroscopic-Guided Osteotomy for Distal Radius Malunion
23.1 Introduction
23.2 Indications and Contraindications
23.3 Operative Technique
23.4 Conclusion
References
24 Arthroscopic-Assisted Scaphoid Fracture Fixation
24.1 Introduction
24.2 Operative Technique
24.2.1 Patient Preparation and Positioning
24.2.2 First Phase: K-Wire Insertion into the Scaphoid
24.2.3 Second Phase: Arthroscopic Checking
24.2.4 Third Phase: Screw Insertion
24.2.5 Final Arthroscopic Checking
24.2.6 Postoperative Care
24.3 Conclusion
Reference
25 Arthroscopic Bone Grafting for Scaphoid Nonunion
25.1 Introduction
25.2 Operative Technique
25.2.1 Patient Preparation and Positioning
25.2.2 Radiocarpal and Midcarpal Exploration
25.2.3 Nonunion Site Preparation
25.2.4 Bone Graft Harvesting
25.2.5 Temporary Fixation of the Nonunion
25.2.6 Graft Implantation and Fixation
25.2.7 Closure and Postoperative Care
25.3 Conclusion
26 Arthroscopic Replacement of the Proximal Pole of the Scaphoid with a Pyrocarbon Implant
26.1 Introduction
26.2 Operative Technique
26.2.1 Patient Preparation and Positioning
26.2.2 Arthroscopic Portals and Exploration
26.2.3 Proximal Pole Excision
26.2.4 Selection of Implant Size
26.2.5 Placement of the Final Implant
26.2.6 Postoperative Care
26.3 Conclusion
References
27 Arthroscopic Arthrolysis of theWrist
27.1 Introduction
27.2 Operative Technique
27.2.1 Patient Preparation and Positioning
27.2.2 Debridement of the Medial Radiocarpal Joint
27.2.3 Resection of the Fibrous Radiocarpal Wall
27.2.4 Debridement of the Radiocarpal Dorsal Recess
27.2.5 Inspection of the Radiocarpal Joint
27.2.6 Debridment of the Midcarpal Joint
27.2.7 Postoperative Care
27.3 Conclusion
28 Arthroscopic Scaphotrapeziotrapezoidal Interposition Arthroplasty
28.1 Introduction
28.2 Operative Technique
28.2.1 Patient Preparation and Positioning
28.2.2 Midcarpal Joint Debridement
28.2.3 Scaphotrapeziotrapezoid Joint Exploration
28.2.4 Distal Resection of the Scaphoid
28.2.5 Implant Selection
28.2.6 Implant Placement
28.2.7 Closure and Postoperative Care
28.3 Conclusion
Reference
29 Arthroscopic Resection Arthroplasty of Thumb Carpometacarpal Joint
29.1 Introduction
29.2 Operative Technique
29.2.1 Patient Preparation and Positioning
29.2.2 Portal Placement and Exploration of the Thumb CMC Joint
29.2.3 Debridement and Denervation of the Thumb CMC Joint
29.2.4 Arthroscopic Resection Arthroplasty: CMC Joint
29.2.5 Arthroscopic Resection Arthroplasty: STT Joint
29.2.6 Tourniquet Removal, Hemostasis, and Pain Control
29.2.7 Closure and Postoperative Care
29.3 Conclusion
References
30 Arthroscopic Thumb Carpometacarpal Interposition Arthroplasty
30.1 Introduction
30.2 Operative Technique
30.2.1 Patient Preparation and Positioning
30.2.2 Exploration of the Thumb Carpometacarpal Joint
30.2.3 Debridement of the Thumb Carpometacarpal Joint
30.2.4 Osteophyte Resection
30.2.5 Placement of Implant
30.2.6 Closure and Postoperative Care
30.3 Conclusion
31 Arthroscopic Interposition Arthroplasty in Stage II Scapholunate Advanced CollapseWrists
31.1 Introduction
31.2 Operative Technique
31.2.1 Patient Preparation and Positioning
31.2.2 Harvesting the Tendon Graft
31.2.3 Debridement and Exploration of Radiocarpal Joint
31.2.4 Styloidectomy
31.2.5 Stabilization of SL Joint Space
31.2.6 Preparation for Interposition Arthroplasty
31.2.7 Passage of the Implant抯 Dorsal Portion
31.2.8 Passage of the Implant抯 Volar Portion
31.2.9 Stabilization of Tendon Graft
31.2.10 Closure and Postoperative Care
31.3 Conclusion
32 Arthroscopic Resection Arthroplasty of the Radial Column for Scapholunate Advanced CollapseWrist
32.1 Introduction
32.2 Surgical Technique
32.2.1 Patient Preparation and Positioning
32.2.2 Arthroscopy
32.2.3 Resection
32.2.4 Completion
32.2.5 Postoperative Care
References
33 Arthroscopic PartialWrist Fusion
33.1 Introduction
33.2 Surgical Technique
33.2.1 Patient Preparation and Positioning
33.2.2 Scaphoidectomy
33.2.3 Exploration of Radiocarpal Joint
33.2.4 Exploration of the Midcarpal Joint
33.2.5 Preparation for Arthrodesis
33.2.6 Hamate Resection
33.2.7 Addition of Bone Graft Material
33.2.8 Fixation of the Arthrodesis
33.2.9 Closure and Postoperative Care
33.3 Conclusion
34 Arthroscopic Assessment of Kienbock抯 Disease
34.1 Introduction
34.2 Technique
34.2.1 Set-Up
34.2.2 Inspection
34.2.3 Simple Procedures and Decision-Making
34.3 Conclusion
References
35 Arthroscopic Bone Grafting for Lunate Ganglion
35.1 Introduction
35.2 Operative Technique
35.2.1 Patient Preparation and Positioning
35.2.2 Radiocarpal Exploration
35.2.3 Locating and Curettage of Cyst
35.2.4 Bone Graft Harvesting
35.2.5 Bone Graft Application
35.2.6 Closure and Postoperative Care
35.3 Conclusion
Index