Tips 'n Tricks for wrist arthroscopy: installation, portals and exploration
Epublication WebSurg.com, Mar 2010;10(03). URL: http://websurg.com/doi/vd01en2935
Wrist arthroscopy allows a thorough exploration of the radiocarpal and midcarpal joints simply by carrying out small portals. This video shows how to achieve them and what can be seen in the wrist. The purpose of this video is to understand the principle of wrist arthroscopy and how to perform the portals in the least invasive way. We can draw tendon-bone elements on the skin in order to create anatomical landmarks. Before using the knife, using a single needle is essential to identify the exact position of portals. We always start the exploration of the wrist with the radiocarpal joint, and the 3-4 portal. To find it, there are several simple ways. Once the scope is entered in the radiocarpal joint, it is possible only by this portal to explore all the articulation from radial styloid to ulnar styloid. Instrumental 6R portal will be performed. The midcarpal joint is narrower than the radiocarpal joint. We start with the ulnar midcarpal portal, the easiest to find, then an instrumental radiocarpal portal will be used. Placing the scope in a radial midcarpal position allows to explore the scapho-trapezoid-trapezium joint distally as well as the dorsal surface of the capitate bone.