Arthroscopic Arthrodesis for Ulnar Wrist Instability and Arthritis
Partial wrist fusion provides a reliable surgical option to treat painful instability and arthritis of the wrist. It eliminates abnormal motion and pain generated through the unstable or arthritic segments of the wrist, while to preserve useful motion and function in the remaining part of the wrist. Recent advance in arthroscopic and percutaneous fixation technique enables most fusion procedures to be accomplished through small surgical accesses, hence minimizing surgical trauma and maximizing motion preservation. Through the radiocarpal or midcarpal joint, the corresponding articular surfaces were denuded of cartilage using arthroscopic burr and curette. Carpal bones involved in the fusion process were then transfixed with K wires percutaneously after alignment corrected and confirmed under fluoroscopic control. Autogenous cancellous bone graft or bone substitute was inserted and impacted to the fusion site through cannula under direct arthroscopic view. Final fixation could be by multiple K wires or cannulated screw system. Early mobilization was encouraged. The current experience of arthroscopic partial wrist fusion for ulnar wrist pain is still limited, but the potential for further development is enormous.
KeywordsBone Graft Bone Substitute Carpal Bone Cannulated Screw Fusion Site
- 7.Dobyns JH (1992) Carpal instability. In: Nakamura R, Linscheid RL, Miura T (eds) Wrist disorders: current concepts and challenges. Springer, TokyoGoogle Scholar
- 10.Garcia-Elias M, Horii E, Berger RA (1991) Individual carpal bone motion. In: An KN, Berger RA, Cooney WP (eds) Biomechanics of the wrist joint. Springer, New YorkGoogle Scholar
- 15.Ho PC, Hung LK (2004) Arthroscopic reconstruction of destabilizing TFCC lesions with tendon graft. In: Proceeding, 9th congress of the International Federation of Societies for surgery of the hand A-0362Google Scholar
- 17.Kaplan EB, Taleisnik J (1984) The wrist. In: Spinner M (ed) Kaplan’s functional and surgical anatomy of the hand, 3rd edn. J.B. Lippincott, PhiladelphiaGoogle Scholar