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Arthroscopy and upper limb surgery

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.
Arthroscopic proximal pole resection, partial scaphoid implant
Proximal pole necrosis of the scaphoid can occur after scaphoid fractures. The replacement of the proximal pole has been tried using many different materials for many years, according to the literature. This technique consists in an arthroscopic debridement of the proximal scaphoid pole, leaving the local ligaments as intact as possible. The proximal pole is substituted by a pyrolitic carbon implant, which has an ovoid shape and fits well into this position. We present the technique and the results of 23 of Prof. Christophe Mathoulin’s patients treated between 1998 and 2007 with 21 good results and only one palmar implant dislocation. Even though good results have been already published in the literature, these results seem closely related to the degree of instability, created by the ligament damage in the scapho-lunate area.

This treatment is therefore a salvage procedure more indicated in elderly people than in young people. On the other hand, it can be a simple and convenient waiting therapy option in other cases.
M Haerle
Lecture
7 years ago
197 views
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0 comments
07:15
Arthroscopic proximal pole resection, partial scaphoid implant
Proximal pole necrosis of the scaphoid can occur after scaphoid fractures. The replacement of the proximal pole has been tried using many different materials for many years, according to the literature. This technique consists in an arthroscopic debridement of the proximal scaphoid pole, leaving the local ligaments as intact as possible. The proximal pole is substituted by a pyrolitic carbon implant, which has an ovoid shape and fits well into this position. We present the technique and the results of 23 of Prof. Christophe Mathoulin’s patients treated between 1998 and 2007 with 21 good results and only one palmar implant dislocation. Even though good results have been already published in the literature, these results seem closely related to the degree of instability, created by the ligament damage in the scapho-lunate area.

This treatment is therefore a salvage procedure more indicated in elderly people than in young people. On the other hand, it can be a simple and convenient waiting therapy option in other cases.
Surgical treatment of scaphoid fractures with arthroscopic control
The objective of this presentation is not to perform an exhaustive review of the surgical treatment of scaphoid fractures but to try to justify our choice to systematically associate an arthroscopic control in with a percutaneous fixation using a cannulated screw in all non- or minimally displaced scaphoid fractures. Scaphoid fractures are frequent but present unique challenges because of the particular geometry of the bone and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures may lead to non-unions that can progress to carpal collapse and degenerative arthritis of the wrist.
Improvements in diagnosis, surgical treatment and implant materials have encouraged a trend towards early internal fixation even for non-displaced scaphoid fractures that could potentially be treated non-operatively. In our experience, wrist arthroscopy is a useful tool in the management of these fractures not only to assess the quality of reduction but also not to overlook severe carpal ligament injuries, which would be untreated and may lead to chronic and symptomatic carpal instability.
X Martinache
Lecture
7 years ago
185 views
5 likes
0 comments
10:12
Surgical treatment of scaphoid fractures with arthroscopic control
The objective of this presentation is not to perform an exhaustive review of the surgical treatment of scaphoid fractures but to try to justify our choice to systematically associate an arthroscopic control in with a percutaneous fixation using a cannulated screw in all non- or minimally displaced scaphoid fractures. Scaphoid fractures are frequent but present unique challenges because of the particular geometry of the bone and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures may lead to non-unions that can progress to carpal collapse and degenerative arthritis of the wrist.
Improvements in diagnosis, surgical treatment and implant materials have encouraged a trend towards early internal fixation even for non-displaced scaphoid fractures that could potentially be treated non-operatively. In our experience, wrist arthroscopy is a useful tool in the management of these fractures not only to assess the quality of reduction but also not to overlook severe carpal ligament injuries, which would be untreated and may lead to chronic and symptomatic carpal instability.
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.