Skip to main content

Overview of Wrist and Hand Approaches: Indications for Minimally Invasive Techniques

  • Chapter
  • First Online:
Minimally Invasive Surgery in Orthopedics
  • 1839 Accesses

Abstract

Orthopedic surgery has seen a recent explosion of minimally invasive techniques17 and the wrist and hand are no exception. These techniques range from percutaneous, endoscopic, arthroscopic, to mini-open procedures. The main topics covered in the following chapters include minimally invasive fixation for wrist fractures, endoscopic carpal tunnel release, minimally invasive trigger finger release, and minimally invasive treatment of finger fractures. Indications and advantages of minimally invasive wrist and hand surgery will be discussed as well as detailed descriptions of these new surgical techniques.

Similar to advantages proposed in other regions of orthopedic surgery, the advantages of minimally invasive techniques for surgery of the wrist and hand include shorter recovery times, earlier return to work, and less scar tissue formation with potentially improved outcomes.8,9 Advances in visualization via endoscopic and arthroscopic cameras and improved anatomic knowledge for increased safety during minimally invasive approaches have helped expand the use and experience in these techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 349.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bottner F, Delgado S, Sculco TP. Minimally invasive total hip replacement: the posterolateral approach. American Journal of Orthopedics (Belle Mead, N.J.) 2006;35(5):218–24

    Google Scholar 

  2. Egol KA. Minimally invasive orthopaedic trauma surgery: a review of the latest techniques. Bulletin (Hospital for Joint Diseases (New York, N.Y.)) 2004;62(1–2):6–12

    Google Scholar 

  3. Klein GR, Parvizi J, Sharkey PF, Rothman RH, Hozack WJ. Minimally invasive total hip arthroplasty: internet claims made by members of the Hip Society. Clinical Orthopaedics and Related Research 2005 Dec;(441):68–70

    Google Scholar 

  4. Langlotz K. Minimally invasive approaches in orthopaedic surgery. Minimally Invasive Therapy and Allied Technologies 2003;12(1):19–24

    PubMed  Google Scholar 

  5. Lehman RA, Jr., Vaccaro AR, Bertagnoli R, Kuklo TR. Standard and minimally invasive approaches to the spine. The Orthopedic Clinics of North America 2005;36(3):281–92

    Article  PubMed  Google Scholar 

  6. Nogler M. Navigated minimal invasive total hip arthroplasty. Surgical Technology International 2004;12:259–62

    PubMed  Google Scholar 

  7. Wall EJ, Bylski-Austrow DI, Kolata RJ, Crawford AH. Endoscopic mechanical spinal hemiepiphysiodesis modifies spine growth. Spine 2005;30(10):1148–53

    Article  PubMed  Google Scholar 

  8. Saw NL, Jones S, Shepstone L, Meyer M, Chapman PG, Logan AM. Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial. The Journal of Hand Surgery (Edinburgh, Lothian) 2003;28(5):444–9

    CAS  Google Scholar 

  9. Trumble TE, Diao E, Abrams RA, Gilbert-Anderson MM. Single-portal endoscopic carpal tunnel release compared with open release: a prospective, randomized trial. The Journal of Bone and Joint Surgery American 2002;84-A(7):1107–15

    Google Scholar 

  10. Weil WM, Trumble TE. Treatment of distal radius fractures with intrafocal (kapandji) pinning and supplemental skeletal stabilization. Hand Clinics 2005;21(3):317–28

    Article  PubMed  Google Scholar 

  11. Duncan SF, Weiland AJ. Minimally invasive reduction and osteosynthesis of articular fractures of the distal radius. Injury 2001;32(Suppl 1):SA14–24

    PubMed  Google Scholar 

  12. Ring D, Jupiter JB. Percutaneous and limited open fixation of fractures of the distal radius. Clinical Orthopaedics and Related Research 2000 Jun;(375):105–15

    Article  Google Scholar 

  13. Geissler WB, Fernandes D. Percutaneous and limited open reduction of intra-articular distal radial fractures. Hand Surgery 2000;5(2):85–92

    Article  CAS  PubMed  Google Scholar 

  14. Auge WK, II, Velazquez PA. The application of indirect reduction techniques in the distal radius: the role of adjuvant arthroscopy. Arthroscopy 2000;16(8):830–5

    Article  PubMed  Google Scholar 

  15. Trumble TE, Wagner W, Hanel DP, Vedder NB, Gilbert M. Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation. The Journal of Hand Surgery 1998;23(3):381–94

    Article  CAS  PubMed  Google Scholar 

  16. Naidu SH, Capo JT, Moulton M, Ciccone W, II, Radin A. Percutaneous pinning of distal radius fractures: a biomechanical study. The Journal of Hand Surgery 1997;22(2):252–7

    Article  CAS  PubMed  Google Scholar 

  17. Slade JF, III, Grauer JN, Mahoney JD. Arthroscopic reduction and percutaneous fixation of scaphoid fractures with a novel dorsal technique. The Orthopedic Clinics of North America 2001;32(2):247–61

    Article  PubMed  Google Scholar 

  18. Slade JF, III, Jaskwhich D. Percutaneous fixation of scaphoid fractures. Hand Clinics 2001;17(4):553–74

    PubMed  Google Scholar 

  19. Slade JF, III, Gutow AP, Geissler WB. Percutaneous internal fixation of scaphoid fractures via an arthroscopically assisted dorsal approach. The Journal of Bone and Joint Surgery American 2002;84-A(Suppl 2):21–36

    Google Scholar 

  20. Slade JF, III, Geissler WB, Gutow AP, Merrell GA. Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach. The Journal of Bone and Joint Surgery American 2003;85-A (Suppl 4):20–32

    Google Scholar 

  21. Slade JF, III, Dodds SD. Minimally invasive management of scaphoid nonunions. Clinical Orthopaedics and Related Research 2006 Apr;(445):108–19

    Google Scholar 

  22. Macdermid JC, Richards RS, Roth JH, Ross DC, King GJ. Endoscopic versus open carpal tunnel release: a randomized trial. The Journal of Hand Surgery 2003;28(3):475–80

    Article  PubMed  Google Scholar 

  23. Thoma A, Veltri K, Haines T, Duku E. A meta-analysis of randomized controlled trials comparing endoscopic and open carpal tunnel decompression. Plastic and Reconstructive Surgery 2004;114(5):1137–46

    Article  PubMed  Google Scholar 

  24. Kretschmer T, Antoniadis G, Borm W, Richter HP. [Pitfalls of endoscopic carpal tunnel release]. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen 2004;75(12):1207–9

    CAS  PubMed  Google Scholar 

  25. Thoma A, Veltri K, Haines T, Duku E. A systematic review of reviews comparing the effectiveness of endoscopic and open carpal tunnel decompression. Plastic and Reconstructive Surgery 2004;113(4):1184–91

    Article  PubMed  Google Scholar 

  26. Uchiyama S, Yasutomi T, Fukuzawa T, Nakagawa H, Kamimura M, Miyasaka T. Median nerve damage during two-portal endoscopic carpal tunnel release. Clinical Neurophysiology 2004;115(1):59–63

    Article  PubMed  Google Scholar 

  27. Varitimidis SE, Herndon JH, Sotereanos DG. Failed endoscopic carpal tunnel release. Operative findings and results of open revision surgery. The Journal of Hand Surgery (Edinburgh, Lothian) 1999;24(4):465–7

    CAS  Google Scholar 

  28. Agee JM, Peimer CA, Pyrek JD, Walsh WE. Endoscopic carpal tunnel release: a prospective study of complications and surgical experience. The Journal of Hand Surgery 1995;20(2):165–71; discussion 172

    Article  CAS  PubMed  Google Scholar 

  29. Chow JC, Hantes ME. Endoscopic carpal tunnel release: thirteen years’ experience with the Chow technique. The Journal of Hand Surgery 2002;27(6):1011–8

    Article  PubMed  Google Scholar 

  30. Chow JC. Endoscopic release of the carpal ligament for carpal tunnel syndrome: long-term results using the Chow technique. Arthroscopy 1999;15(4):417–21

    Article  CAS  PubMed  Google Scholar 

  31. Slesarenko YA, Mallo G, Hurst LC, Sampson SP, Serra-Hsu F. Percutaneous release of A1 pulley. Techniques in Hand & Upper Extremity Surgery 2006;10(1):54–6

    Article  Google Scholar 

  32. Ragoowansi R, Acornley A, Khoo CT. Percutaneous trigger finger release: the “lift-cut” technique. British Journal of Plastic Surgery 2005;58(6):817–21

    Article  CAS  PubMed  Google Scholar 

  33. Wilhelmi BJ, Mowlavi A, Neumeister MW, Bueno R, Lee WP. Safe treatment of trigger finger with longitudinal and transverse landmarks: an anatomic study of the border fingers for percutaneous release. Plastic and Reconstructive Surgery 2003;112(4):993–9

    Article  PubMed  Google Scholar 

  34. Wilhelmi BJ, Snyder NT, Verbesey JE, Ganchi PA, Lee WP. Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plastic and Reconstructive Surgery 2001;108(4):908–15

    Article  CAS  PubMed  Google Scholar 

  35. Blumberg N, Arbel R, Dekel S. Percutaneous release of trigger digits. The Journal of Hand Surgery (Edinburgh, Lothian) 2001;26(3):256–7

    CAS  Google Scholar 

  36. Ha KI, Park MJ, Ha CW. Percutaneous release of trigger digits. The Journal of Bone and Joint Surgery 2001;83(1):75–7

    Article  CAS  Google Scholar 

  37. Dunn MJ, Pess GM. Percutaneous trigger finger release: a comparison of a new push knife and a 19-gauge needle in a cadaveric model. The Journal of Hand Surgery 1999;24(4):860–5

    Article  CAS  PubMed  Google Scholar 

  38. Cihantimur B, Akin S, Ozcan M. Percutaneous treatment of trigger finger. 34 fingers followed 0.5–2 years. Acta Orthopaedica Scandinavica 1998;69(2):167–8

    Article  CAS  PubMed  Google Scholar 

  39. Bain GI, Turnbull J, Charles MN, Roth JH, Richards RS. Percutaneous A1 pulley release: a cadaveric study. The Journal of Hand Surgery 1995;20(5):781–4; discussion 785–6

    Article  CAS  PubMed  Google Scholar 

  40. Pope DF, Wolfe SW. Safety and efficacy of percutaneous trigger finger release. The Journal of Hand Surgery 1995;20(2):280–3

    Article  CAS  PubMed  Google Scholar 

  41. Geissler WB. Cannulated percutaneous fixation of intra-articular hand fractures. Hand Clinics 2006;22(3):297–305, vi

    Article  PubMed  Google Scholar 

  42. Sawaizumi T, Nanno M, Nanbu A, Ito H. Percutaneous leverage pinning in the treatment of Bennett’s fracture. Journal of Orthopaedic Science 2005;10(1):27–31

    Article  PubMed  Google Scholar 

  43. Galanakis I, Aligizakis A, Katonis P, Papadokostakis G, Stergiopoulos K, Hadjipavlou A. Treatment of closed unstable metacarpal fractures using percutaneous transverse fixation with Kirschner wires. The Journal of Trauma 2003;55(3):509–13

    Article  PubMed  Google Scholar 

  44. Klein DM, Belsole RJ. Percutaneous treatment of carpal, metacarpal, and phalangeal injuries. Clinical Orthopaedics and Related Research 2000 Jun;(375):116–25

    Article  Google Scholar 

  45. Freeland AE, Orbay JL. Extraarticular hand fractures in adults: a review of new developments. Clinical Orthopaedics and Related Research 2006 Apr;(445):133–45

    Google Scholar 

  46. Mader K, Gausepohl T, Pennig D. [Minimally invasive management of metacarpal I fractures with a mini-fixateur]. Handchir Mikrochir Plast Chir 2000;32(2):107–11

    Article  CAS  PubMed  Google Scholar 

  47. McCulley SJ, Hasting C. External fixator for the hand: a quick, cheap and effective method. Journal of the Royal College of Surgeons of Edinburgh 1999;44(2):99–102

    CAS  PubMed  Google Scholar 

  48. Drenth DJ, Klasen HJ. External fixation for phalangeal and metacarpal fractures. The Journal of Bone and Joint Surgery 1998;80(2):227–30

    Article  CAS  Google Scholar 

  49. Seitz WH, Jr., Gomez W, Putnam MD, Rosenwasser MP. Management of severe hand trauma with a mini external fixateur. Orthopedics 1987;10(4):601–10

    PubMed  Google Scholar 

  50. Slade JF, III, Gutow AP. Arthroscopy of the metacarpophalangeal joint. Hand Clinics 1999;15(3):501–27

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steve K. Lee .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Lee, S.K. (2010). Overview of Wrist and Hand Approaches: Indications for Minimally Invasive Techniques. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76608-9_13

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-76608-9_13

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-76607-2

  • Online ISBN: 978-0-387-76608-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics