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. 2024 Jun 22;59(3):e349-e357.
doi: 10.1055/s-0044-1779336. eCollection 2024 Jun.

Arthroscopy-assisted Procedures in Hand and Wrist Surgery: An Update. Where Are We So Far?

Diego Figueira Falcochio  1 , João Pedro Farina Brunelli  2 , Ricardo Kaempf de Oliveira  2 , Gustavo Mantovani Ruggiero  3
Affiliations

Arthroscopy-assisted Procedures in Hand and Wrist Surgery: An Update. Where Are We So Far?

Diego Figueira Falcochio et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Wrist and hand arthroscopy, despite being an old tool, has gained popularity and advanced in assisting in the treatment of various injuries and conditions in the region in recent years. Dorsal, volar, ulnar, and radial accessory portals are used to reach all points of the carpal and hand joints. The minimal tissue damage, lesser injury to the capsule and its mechanoreceptors, the assessment of injuries associated with the reason for surgery, and aesthetically more favorable scars have attracted many doctors and their patients. As a result, there has been an increase in publications and diversifications of arthroscopic techniques. The aim of this update article is to present the advances and the evidence available in the literature to assist readers in their decision on which technique to use in the treatment of wrist and hand conditions.

Keywords: arthroscopy; pseudarthrosis; scaphoid bone; synovial cyst; wrist.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

Figures

Fig. 1
Fig. 1
Wrist arthroscopy portals. A: portals 1-2, B: portals 3-4, C: portal 6R, D: portal 6U, E: radial mid-carpal portal (RMC), F: ulnar mid-carpal portal (UMC). VR: volar radial, VU: volar ulnar.
Fig. 2
Fig. 2
Wrist arthroscopy for scaphoid non-union treatment. A: patient positioning. B: Scrapping of the scaphoid non-union with a curette through the radial mid-carpal portal. C: Scrapping and positioning through the radiocarpal portal. D: Scrapping through the volar aspect of the scaphoid.
Fig. 3
Fig. 3
Types of triangular fibrocartilage complex (TFCC) injuries. A: Distal detachment of the TFCC, class 1. B: Proximal and distal detachment of the TFCC, class 2. C: Positive "hook" test for the injury shown in figure B (class 2). D: TFCC class 4 injury with friable edges. E: The same patient as shown in figure B, with significant instability of the remaining TFCC. F: Massive irreparable TFCC class 4 injury.
Fig. 1
Fig. 1
Portais para artroscopia do punho. A: portal 1-2, B: portal 3-4, C: portal 6R, D: portal 6U, E: portal médio-carpal radial (MCR), F: portal médio-carpal ulnar (MCU).VR: volar radial, VU: volar ulnar.
Fig. 2
Fig. 2
Artroscopia do punho para o tratamento da pseudartrose do escafoide. A: posicionamento do paciente. B: Cruentização da pseudartrose com cureta por portal médio-cárpico radial. C: Cruentização e posicionamento com portal rádio-cárpico. D: Cruentização por volar do escafoide.
Fig. 3
Fig. 3
Tipos de lesão do complexo da fibrocartilagem triangular. A: desinserção distal do CFCT, classe 1. B: Desinseção proximal e distal do CFCT, classe 2. C: Demonstração do teste do “gancho” positivo para a lesão demonstrada na figura B (classe 2). D: lesão do CFCT classe 4 com bordas friáveis. E: mesma paciente demonstrada na figura B, com grande instabilidade dos remanescentes do CFCT. F: lesão maciça do CFCT, irreparável, classe 4.
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