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Arthroscopy for Adult Hand Fractures

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Pediatric and Adult Hand Fractures

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Abstract

Small joint arthroscopy of the hand was first described over 40 years ago. In the subsequent decades, this minimally invasive technology has proven to be an invaluable addition to the hand surgeon’s armamentarium. Arthroscopy of the carpometacarpal, metacarpophalangeal joints, and interphalangeal joints allows for detailed evaluation while minimizing damage to the local soft tissues when compared to traditional open techniques. Arthroscopy has become commonplace in the staging and treatment of various degenerative joint diseases afflicting the small joints of the hand. However, far less literature is available regarding the arthroscopically aided reduction and fixation of common intra-articular hand fractures. Direct arthroscopic visualization of these fractures represents a distinct advantage to purely open or percutaneous techniques, as anatomic reduction can not only be achieved and maintained throughout the case, but also confirmed after fixation. In this chapter, we sought to summarize the role of arthroscopy in the management of intra-articular hand fractures and detail our own surgical techniques.

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References

  1. Watanabe M. Present status and future of arthroscopy. Geka Chiryo. 1972;26(1):73–7. Japanese.

    CAS  PubMed  Google Scholar 

  2. Chen YC. Arthroscopy of the wrist and finger joints. Orthop Clin North Am. 1979;10(3):723–33.

    CAS  PubMed  Google Scholar 

  3. Badia A. Arthroscopy of the trapeziometacarpal and metacarpophalangeal joints. J Hand Surg [Am]. 2007;32(5):707–24.

    Article  Google Scholar 

  4. Berger RA. A technique for arthroscopic evaluation of the first carpometacarpal joint. J Hand Surg [Am]. 1997;22(6):1077–80.

    Article  CAS  Google Scholar 

  5. Badia A. Trapeziometacarpal arthroscopy: a classification and treatment algorithm. Hand Clin. 2006;22(2):153–63.

    Article  PubMed  Google Scholar 

  6. Menon J. Arthroscopic management of trapeziometacarpal joint arthritis of the thumb. Arthroscopy. 1996;12(5):581–7.

    Article  CAS  PubMed  Google Scholar 

  7. Osterman AL, Culp R, Bednar J. Arthroscopy of the thumb carpometacarpal joint. Arthroscopy. 1997;13(3):411.

    Article  Google Scholar 

  8. Culp RW, Rekant MS. The role of arthroscopy in evaluating and treating trapeziometacarpal disease. Hand Clin. 2001;17(2):315–9.

    Article  CAS  PubMed  Google Scholar 

  9. Longo UG, Petrillo S, Denaro V. Current concepts in the management of rheumatoid hand. Int J Rheumatol. 2015;2015:648073.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Burke FD. The rheumatoid metacarpophalangeal joint. Hand Clin. 2011;27(1):79–86.

    Article  PubMed  Google Scholar 

  11. Rizzo M. Metacarpophalangeal joint arthritis. J Hand Surg [Am]. 2011;36(2):345–53.

    Article  Google Scholar 

  12. Berner SH. Metacarpophalangeal arthroscopy: technique and applications. Tech Hand Up Extrem Surg. 2008;12(4):208–15.

    Article  PubMed  Google Scholar 

  13. Rozmaryn LM, Wei N. Metacarpophalangeal arthroscopy. Arthroscopy. 1999;15(3):333–7.

    Article  CAS  PubMed  Google Scholar 

  14. Sekiya I, Kobayashi M, Taneda Y, Matsui N. Arthroscopy of the proximal interphalangeal and metacarpophalangeal joints in rheumatoid hands. Arthroscopy. 2002;18(3):292–7.

    Article  PubMed  Google Scholar 

  15. Ostendorf B, Dann P, Wedekind F, Brauckmann U, Friemann J, Koebke J, Schulitz KP, Schneider M. Miniarthroscopy of metacarpophalangeal joints in rheumatoid arthritis. Rating of diagnostic value in synovitis staging and efficiency of synovial biopsy. J Rheumatol. 1999;26(9):1901–8.

    CAS  PubMed  Google Scholar 

  16. Wilkes LL. Arthroscopic synovectomy in the rheumatoid metacarpophalangeal joint. J Med Assoc GA. 1987;76(9):638–9.

    CAS  PubMed  Google Scholar 

  17. Wei N, Delauter SK, Erlichman MS, Rozmaryn LM, Beard SJ, Henry DL. Arthroscopic synovectomy of the metacarpophalangeal joint in refractory rheumatoid arthritis: a technique. Arthroscopy. 1999;15(3):265–8.

    Article  CAS  PubMed  Google Scholar 

  18. Choi AK, Chow EC, Ho PC, Chow YY. Metacarpophalangeal joint arthroscopy: indications revisited. Hand Clin. 2011;27(3):369–82.

    Article  PubMed  Google Scholar 

  19. Capo JT, Kinchelow T, Orillaza NS, Rossy W. Accuracy of fluoroscopy in closed reduction and percutaneous fixation of simulated Bennett’s fracture. J Hand Surg [Am]. 2009;34(4):637–41.

    Article  Google Scholar 

  20. Caldwell RA, Shorten PL, Morrell NT. Common upper extremity fracture eponyms: a look into what they really mean. J Hand Surg [Am]. 2019;44(4):331–4.

    Article  Google Scholar 

  21. Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green’s operative hand surgery. 8th ed. Philadelphia, PA: Elsevier; 2021.

    Google Scholar 

  22. Solomon J, Culp RW. Arthroscopic management of Bennett fracture. Hand Clin. 2017;33(4):787–94.

    Article  PubMed  Google Scholar 

  23. Ellis H. Edward Hallaran Bennett: Bennett’s fracture of the base of the thumb. J Perioper Pract. 2013;23(3):59–60.

    PubMed  Google Scholar 

  24. Bettinger PC, Berger RA. Functional ligamentous anatomy of the trapezium and trapeziometacarpal joint (gross and arthroscopic). Hand Clin. 2001;17(2):151–68.

    Article  CAS  PubMed  Google Scholar 

  25. Gedda KO. Studies on Bennett’s fracture; anatomy, roentgenology, and therapy. Acta Chir Scand Suppl. 1954;193:1–114.

    CAS  PubMed  Google Scholar 

  26. Guss MS, Kaye D, Rettig M. Bennett fractures a review of management. Bull Hosp Jt Dis. 2016;74(3):197–202.

    Google Scholar 

  27. Ladd AL. Guest editorial: The Robert’s view: a historical and clinical perspective. Clin Orthop Relat Res. 2014;472(4):1097–100.

    Article  PubMed  Google Scholar 

  28. Culp RW, Johnson JW. Arthroscopically assisted percutaneous fixation of Bennett fractures. J Hand Surg [Am]. 2010;35(1):137–40.

    Article  Google Scholar 

  29. Pomares G, Strugarek-Lecoanet C, Dap F, Dautel G. Bennett fracture: arthroscopically assisted percutaneous screw fixation versus open surgery: functional and radiological outcomes. Orthop Traumatol Surg Res. 2016;102(3):357–61.

    Article  CAS  PubMed  Google Scholar 

  30. Zemirline A, Lebailly F, Taleb C, Facca S, Liverneaux P. Arthroscopic assisted percutaneous screw fixation of Bennett’s fracture. Hand Surg. 2014;19(2):281–6.

    Article  PubMed  Google Scholar 

  31. Sekiya I, Kobayashi M, Okamoto H, Iguchi H, Waguri-Nagaya Y, Goto H, Nozaki M, Tsuchiya A, Otsuka T. Arthroscopic synovectomy of the metacarpophalangeal and proximal interphalangeal joints. Tech Hand Up Extrem Surg. 2008;12(4):221–5.

    Article  PubMed  Google Scholar 

  32. Ryu J, Fagan R. Arthroscopic treatment of acute complete thumb metacarpophalangeal ulnar collateral ligament tears. J Hand Surg [Am]. 1995;20(6):1037–42.

    Article  CAS  Google Scholar 

  33. Vaupel GL, Andrews JR. Diagnostic and operative arthroscopy of the thumb metacarpophalangeal joint. A case report. Am J Sports Med. 1985;13(2):139–41.

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  35. Sekiya I, Kobayashi M, Okamoto H, Otsuka T. Progress and role of finger joint arthroscopy. Hand Clin. 2017;33(4):819–29.

    Article  PubMed  Google Scholar 

  36. Walsh EF, Akelman E, Fleming BC, Da Silva MF. Thumb carpometacarpal arthroscopy: a topographic, anatomic study of the thenar portal. J Hand Surg [Am]. 2005;30(2):373–9.

    Article  Google Scholar 

  37. Cobb TK, Berner SH, Badia A. New frontiers in hand arthroscopy. Hand Clin. 2011;27(3):383–94.

    Article  PubMed  Google Scholar 

  38. Daley D, Geary M, Gaston RG. Thumb metacarpophalangeal ulnar and radial collateral ligament injuries. Clin Sports Med. 2020;39(2):443–55.

    Article  PubMed  Google Scholar 

  39. Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg. 2011;19(5):287–96.

    Article  PubMed  Google Scholar 

  40. Keramidas E, Miller G. Adult hand injuries on artificial ski slopes. Ann Plast Surg. 2005;55(4):357–8.

    Article  CAS  PubMed  Google Scholar 

  41. Coyle MP Jr. Grade III radial collateral ligament injuries of the thumb metacarpophalangeal joint: treatment by soft tissue advancement and bony reattachment. J Hand Surg [Am]. 2003;28(1):14–20.

    Article  Google Scholar 

  42. Johnson JW, Culp RW. Acute ulnar collateral ligament injury in the athlete. Hand Clin. 2009;25(3):437–42.

    Article  PubMed  Google Scholar 

  43. Heyman P, Gelberman RH, Duncan K, Hipp JA. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing. Clin Orthop Relat Res. 1993;(292):165–71.

    Google Scholar 

  44. Avery DM III, Caggiano NM, Matullo KS. Ulnar collateral ligament injuries of the thumb: a comprehensive review. Orthop Clin North Am. 2015;46(2):281–92.

    Article  PubMed  Google Scholar 

  45. Edelstein DM, Kardashian G, Lee SK. Radial collateral ligament injuries of the thumb. J Hand Surg [Am]. 2008;33(5):760–70.

    Article  Google Scholar 

  46. Gerber C, Senn E, Matter P. Skier’s thumb. Surgical treatment of recent injuries to the ulnar collateral ligament of the thumb’s metacarpophalangeal joint. Am J Sports Med. 1981;9(3):171–7.

    Article  CAS  PubMed  Google Scholar 

  47. Campbell CS. Gamekeeper’s thumb. J Bone Joint Surg (Br). 1955;37(1):148–9.

    Article  PubMed  Google Scholar 

  48. Newland CC. Gamekeeper’s thumb. Orthop Clin North Am. 1992;23(1):41–8.

    Article  CAS  PubMed  Google Scholar 

  49. Posner MA, Retaillaud JL, Green SM. Collateral ligament ruptures of the thumb metacarpophalangeal joint a review of 500 surgical cases. Bull Hosp Jt Dis. 2022;80(2):122–8.

    Google Scholar 

  50. Giele H, Martin J. The two-level ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb. J Hand Surg (Br). 2003;28(1):92–3.

    Article  CAS  PubMed  Google Scholar 

  51. Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb. J Bone Joint Surg. 1962;44B(4):869–79.

    Article  Google Scholar 

  52. Lark ME, Maroukis BL, Chung KC. The Stener lesion: historical perspective and evolution of diagnostic criteria. Hand. 2017;12(3):283–9.

    Article  PubMed  Google Scholar 

  53. Köttstorfer J, Hofbauer M, Krusche-Mandl I, Kaiser G, Erhart J, Platzer P. Avulsion fracture and complete rupture of the thumb radial collateral ligament. Arch Orthop Trauma Surg. 2013;133(4):583–8.

    Article  PubMed  Google Scholar 

  54. Badia A. Arthroscopic reduction and internal fixation of bony gamekeeper’s thumb. Orthopedics. 2006;29(8):675–8.

    Article  PubMed  Google Scholar 

  55. Gáspár L, Szekanecz Z, Dezso B, Szegedi G, Csernátony Z, Szepesi K. Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope. Knee Surg Sports Traumatol Arthrosc. 2003;11(1):50–2.

    Article  PubMed  Google Scholar 

  56. Erdos J, Gannon C, Baratz ME. Arthroscopy of the metacarpophalangeal joint. Oper Tech Orthop. 2007;17:133–9.

    Article  Google Scholar 

  57. Diao E. Metacarpal fixation. Hand Clin. 1997;13(4):557–71.

    Article  CAS  PubMed  Google Scholar 

  58. Brewerton DA. A tangential radiographic projection for demonstrating involvement of metacarpal heads in rheumatoid arthritis. Br J Radiol. 1967;40(471):233–4.

    Article  CAS  PubMed  Google Scholar 

  59. Lane CS. Detecting occult fractures of the metacarpal head: the Brewerton view. J Hand Surg [Am]. 1977;2(2):131–3.

    Article  CAS  Google Scholar 

  60. McElfresh EC, Dobyns JH. Intra-articular metacarpal head fractures. J Hand Surg [Am]. 1983;8(4):383–93.

    Article  CAS  Google Scholar 

  61. Lee JK, Jo YG, Kim JW, Choi YS, Han SH. Open reduction and internal fixation for intraarticular fracture of metacarpal head. Orthopade. 2017;46(7):617–24.

    Article  PubMed  Google Scholar 

  62. Ford DJ, El-Hadidi S, Lunn PG, Burke FD. Fractures of the metacarpals: treatment by A. O. screw and plate fixation. J Hand Surg (Br). 1987;12(1):34–7.

    Article  CAS  PubMed  Google Scholar 

  63. Ouellette EA, Freeland AE. Use of the minicondylar plate in metacarpal and phalangeal fractures. Clin Orthop Relat Res. 1996;(327):38–46.

    Google Scholar 

  64. Sudhakar JE, Smith AM, Leslie IJ. Late treatment of a displaced intraarticular metacarpal head fracture. J Hand Surg (Br). 1997;22(5):672–3.

    Article  CAS  PubMed  Google Scholar 

  65. Hastings H II, Carroll C IV. Treatment of closed articular fractures of the metacarpophalangeal and proximal interphalangeal joints. Hand Clin. 1988;4(3):503–27.

    Article  PubMed  Google Scholar 

  66. Light TR, Bednar MS. Management of intra-articular fractures of the metacarpophalangeal joint. Hand Clin. 1994;10(2):303–14.

    Article  CAS  PubMed  Google Scholar 

  67. Shewring DJ, Thomas RH. Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers. J Hand Surg (Br). 2006;31(5):537–41.

    Article  CAS  PubMed  Google Scholar 

  68. Henry MH. Fractures of the proximal phalanx and metacarpals in the hand: preferred methods of stabilization. J Am Acad Orthop Surg. 2008;16(10):586–95.

    Article  PubMed  Google Scholar 

  69. Boulas HJ, Herren A, Büchler U. Osteochondral metatarsophalangeal autografts for traumatic articular metacarpophalangeal defects: a preliminary report. J Hand Surg [Am]. 1993;18(6):1086–92.

    Article  CAS  Google Scholar 

  70. Boulas HJ. Autograft replacement of small joint defects in the hand. Clin Orthop Relat Res. 1996;(327):63–71.

    Google Scholar 

  71. Hidalgo-Díaz JJ, Ichihara S, Taleb C, Gouzou S, Facca S, Naroura I, Bodin F, Liverneaux P. Metacarpophalangeal joint arthroscopy in the fingers other than the thumb: retrospective comparison of horizontal versus vertical traction. Chir Main. 2015;34(3):105–8.

    Article  PubMed  Google Scholar 

  72. Eberlin KR, Babushkina A, Neira JR, Mudgal CS. Outcomes of closed reduction and periarticular pinning of base and shaft fractures of the proximal phalanx. J Hand Surg [Am]. 2014;39(8):1524–8.

    Article  Google Scholar 

  73. Kuhn KM, Dao KD, Shin AY. Volar A1 pulley approach for fixation of avulsion fractures of the base of the proximal phalanx. J Hand Surg [Am]. 2001;26(4):762–71.

    Article  CAS  Google Scholar 

  74. Sakuma M, Nakamura R, Inoue G, Horii E. Avulsion fracture of the metacarpophalangeal joint of the finger. J Hand Surg (Br). 1997;22(5):667–71.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Jack G. Graham

  2. Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    A. Lee Osterman

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  1. Jack G. Graham
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  2. A. Lee Osterman
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Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joshua M. Abzug

  2. Atrium Health Carolinas Medical Center, Charlotte, NC, USA

    R. Glenn Gaston

  3. Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    A. Lee Osterman

  4. Rothman Orthopaedic Institute Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

    Richard J. Tosti

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Graham, J.G., Osterman, A.L. (2023). Arthroscopy for Adult Hand Fractures. In: Abzug, J.M., Gaston, R.G., Osterman, A.L., Tosti, R.J. (eds) Pediatric and Adult Hand Fractures. Springer, Cham. https://doi.org/10.1007/978-3-031-32072-9_20

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  • DOI: https://doi.org/10.1007/978-3-031-32072-9_20

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