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Jean-Michel COGNET

Polyclinique St André - SOS Mains
Reims, France
MD
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Arthroscopic reduction of intra-articular distal radius fractures: practical explanations, tips and tricks
The interest of wrist arthroscopy for the treatment of intra-articular fractures of the distal radius has been demonstrated in the literature for several years. This surgical technique requires specific instrumentation,
like a tower traction, small size optics and small tools. Once the stabilization of the wrist has been performed (using K-wires or plates), an arthroscopic control allows to appreciate the reduction of the fracture, and to diagnose and treat ligamentous injuries. Reduction of the fracture is
sometimes not sufficient and can be carried out under arthroscopic control using K-wires as a joystick. This surgical technique needs a learning curve to be able to treat difficult articular fractures of the distal radius. Using arthroscopy, the follow-up of operated articular fractures of the distal radius is easier for the surgeon and the patient.
JM Cognet
Lecture
7 years ago
201 views
1 like
0 comments
13:30
Arthroscopic reduction of intra-articular distal radius fractures: practical explanations, tips and tricks
The interest of wrist arthroscopy for the treatment of intra-articular fractures of the distal radius has been demonstrated in the literature for several years. This surgical technique requires specific instrumentation,
like a tower traction, small size optics and small tools. Once the stabilization of the wrist has been performed (using K-wires or plates), an arthroscopic control allows to appreciate the reduction of the fracture, and to diagnose and treat ligamentous injuries. Reduction of the fracture is
sometimes not sufficient and can be carried out under arthroscopic control using K-wires as a joystick. This surgical technique needs a learning curve to be able to treat difficult articular fractures of the distal radius. Using arthroscopy, the follow-up of operated articular fractures of the distal radius is easier for the surgeon and the patient.
Arthroscopic radial styloidectomy: technique, indication, results
The first case of arthroscopic radial styloidectomy was reported by Ruch in 1998.
Indications of radial styloidectomy are relative to radioscaphoidal impingement without alteration of the mid-carpal joint by degenerative arthritis (SNAC and SLAC stage 1 and 2). Pseudarthrosis of the radial styloid is another rare indication of radial styloidectomy.
The quantity of radius to remove was evaluated in different studies between 3 and 4mm. Removing more than 4mm of radius may lead to a destabilization of the wrist due to the insertion of ligaments on the anterior marginal part of the radius. No case of carpal destabilization after radial styloidectomy was reported in the literature.
The design of osteotomy may be different depending on the origin of the conflict. SNAC and SLAC lead to different kinds of arthritis and impingement.
Arthrocopy is a very useful tool to carry out radial styloidectomy; it is a minimally invasive procedure with the possibility of early rehabilitation. In case of poor results, there is still a place for open surgery.
To better visualize the expert's powerpoint presentation, please click here.
JM Cognet
Lecture
8 years ago
357 views
2 likes
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12:16
Arthroscopic radial styloidectomy: technique, indication, results
The first case of arthroscopic radial styloidectomy was reported by Ruch in 1998.
Indications of radial styloidectomy are relative to radioscaphoidal impingement without alteration of the mid-carpal joint by degenerative arthritis (SNAC and SLAC stage 1 and 2). Pseudarthrosis of the radial styloid is another rare indication of radial styloidectomy.
The quantity of radius to remove was evaluated in different studies between 3 and 4mm. Removing more than 4mm of radius may lead to a destabilization of the wrist due to the insertion of ligaments on the anterior marginal part of the radius. No case of carpal destabilization after radial styloidectomy was reported in the literature.
The design of osteotomy may be different depending on the origin of the conflict. SNAC and SLAC lead to different kinds of arthritis and impingement.
Arthrocopy is a very useful tool to carry out radial styloidectomy; it is a minimally invasive procedure with the possibility of early rehabilitation. In case of poor results, there is still a place for open surgery.
To better visualize the expert's powerpoint presentation, please click here.