Introduction
Wrist Arthroscopy is a keyhole surgical procedure where a camera (arthroscope) and instruments are inserted into the wrist joint through a number of small incisions (2-3mm). A number of wrist conditions can be diagnosed and treated this way.
Because small incisions are used, this surgery is less invasive and potentially less painful with quicker recovery.
The wrist is comprised of 2 large bones and 8 smaller ones. They are connected by a number of ligaments.
Indications
Conditions treated by wrist arthroscopy include:
Undiagnosed Wrist Pain
Sometimes the cause of wrist pain is not clear and arthroscopy can help visualise the joint and identify the problem.
Triangular Fibrocartilage Complex (TFCC) Injury
The TFCC is a soft tissue structure that helps stabilise and cushion the wrist. Triangular Fibrocartilage Complex (TFCC) Injury can be diagnosed and treated with wrist arthroscopy.
Ganglion Excision
Ganglion cysts can arise from the wrist joint. Wrist Ganglions and Cysts can be diagnosed and treated with wrist arthroscopy – allowing the surgeon to view the ganglion and excise it.
Fractures
Arthroscopy can help visualise fractures and aid in aligning of fractures involving the scaphoid or radius.
Infection
Infection / Pus build up in joint can be washed out.
Stiffness
Soft tissue scarring and fibrosis within the joint can be resected to improve movement.
Procedure
This procedure is usually day only. The procedure is performed under general anaesthesia. The procedure takes 30-90minutes depending on case complexity.
A tourniquet is placed above the elbow to minimise bleeding. The nerves and proposed incisions are marked out on the skin to minimize risk of damage.
The incisions are approximately 2-3mm. Usually two to four small incisions are made at the back of the wrist. Fluid is used to distend the joint and aid vision. A 1.9mm camera is inserted through one incision and instruments (e.g.: grasper / shaver) are inserted and procedure is carried out.
At the end of the procedure, the skin is closed with dissolvable sutures and dressed. The arm may be placed in a plaster depending on the condition being treated.
Recovery
The arm may be plaster slab depending on the surgery and you are discharged from hospital on painkillers.
The arm should be elevated for the first 2-3 days after surgery to minimise swelling and pain. Regular finger movement exercise will also help with stiffness and swelling.
Hand therapy may be required after surgery depending on the condition. Return to driving/work/sport depends on the type of procedure.
Risks and complications
These include:
- Nerve injury.
- Bleeding.
- Infection.