TFCC current concept

In this key lecture, Dr. Messina focuses on scapholunate tears and on the importance of their early diagnosis.

In this key lecture, Dr. Camus outlines the wrist arthroscopic dorsal capsuloligamentous repair.

In this key lecture, Dr. Muratore outlines wrist arthroscopic anatomy.

In this key lecture, Dr. Camus looks into the management of associated lesions in distal radius fractures

In recent years, the scapholunate ligament has been targeted by numerous studies that have allowed to better understand its complexity. It is likely that we are entering a new era of understanding the true features of the scapholunate complex, including intrinsic and extrinsic ligaments. This will probably lead to a new way of repair in the near future. Wrist arthroscopy is obviously the perfect tool for that. The round table is led by two chairmen, Diego Fernandez and Laurent Obert. They interview internationally recognized experts in the treatment of these lesions.

In this key lecture, Dr. Gras looks into long-term results of arthroscopic replacement of necrotic proximal pole with APSI implant.

Osteoarthritis of the first carpometacarpal joint is frequent and painful. The use of a ligamentoplasty following trapeziectomy is a simple technique, using only a single dorsal approach. The “hammock” ligamentoplasty using the abductor pollicis longus tendon slips allows to maintain the distance between the scaphoid and the base of the first metacarpal bone while preserving the flexor carpi radialis tendon and weakening the force dislocating the abductor pollicis longus.

The arthroscopic resection of wrist ganglia is a sure technique, which allows a satisfactory resection of the cyst and of the adjacent articular capsule. The rate of recurrence does not seem as low as initially but stays in levels comparable to the best series of classical open techniques. The long follow-up of this report discusses the notion of true recurrence or return of a new cyst. Nevertheless, the satisfaction rate of the patients is very high particularly because there is neither cutaneous suture, nor immobilization of the wrist.

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.

In this key lecture, Dr. Yanni goes over arthroscopic radial styloidectomy.