Anatomical and safety considerations in establishing portals used for wrist arthroscopy

Grechenig, W.; Peicha, G.; Fellinger, M.; Seibert, F. J.; Weiglein, A.

doi:10.1002/(sici)1098-2353(1999)12:3<179::aid-ca6>3.0.co;2-9

Cited by 31 publications

(15 citation statements)

References 5 publications

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“…Neurological injury resulting from arthroscopic procedures was commonly described in the literature [21]; many of them were transient, but complete nerve avulsion and neuroma formation have been reported [22, 23]. Injury to the dorsal sensory branches of the ulnar nerve seems to be among the most frequent neurologic complications [9].…”

Section: Discussionmentioning

confidence: 99%

Results of Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tear With Exploration of Dorsal Sensory Branch of Ulnar Nerve

Chen

Weng²,

Chiu³

et al. 2017

TOORTHJ

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Background:Ulnar-sided approach in arthroscopic triangular fibrocartilage complex (TFCC) repair may jeopardize treatment success by exposing the dorsal sensory branch of ulnar nerve (DSBUN) in risk of injury. We aim to conduct a follow-up assessment of arthroscopic outside-in TFCC repair and efficacy of sensory nerve exploration.Methods:We conducted a retrospective chart review of 58 patients (59 wrists) who received arthroscopic repair of the peripheral attachment of the TFCC. Ulnar-sided skin incision and exploration of DSBUN were performed before arthroscopy setting. Arthroscopic outside-in repair through pullout suture ligation was performed. Functional survey at 6 months and 1 year postoperatively was based on Mayo Modified Wrist Score (MMWS), and compared to the preoperative assessment. A p-value of less than 0.05 was considered significant as calculated using paired t-test.Results:Postoperative MMWS averaged 74.32±11.50 at 6 months, and 84.41±9.52 at one year; both showed significant difference as compared to preoperative status. Significant improvement was noted in all 4 individual items except motion retrieval between 6 months and 1 year. Totally, 45 (76%) cases achieved good or excellent results at one year; however, less patients resumed pre-injury activity level when treatment delay was more than 6 months than those treated earlier (41% vs. 57%). Complication included 6 transient paresthesia; 1 anchor migration and 1 distal radioulnar arthrosis. No more nerve complication was found after modification of perineural dissection.Conclusion:Arthroscopy is effective in obtaining both correct diagnosis and treatment of peripheral TFCC tear. Modified perineural dissection can minimize sensory nerve complications.

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Section: Discussionmentioning

confidence: 99%

Results of Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tear With Exploration of Dorsal Sensory Branch of Ulnar Nerve

Chen

Weng²,

Chiu³

et al. 2017

TOORTHJ

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“…Many of these are transient (Beredjiklian et al, 2004;Grechenig et al,1999), but there have been a few reports of neurological injury confirmed by surgical exploration, some of which have been at the wrist. Del Pinal et al (1999) reported one case of complete avulsion of the distal posterior interosseous nerve at wrist arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

Injury of the Dorsal Sensory Branch of the Ulnar Nerve as a Complication of Arthroscopic Repair of the Triangular Fibrocartilage

Chen

Wei

Huang

2006

Journal of Hand Surgery

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This report presents a case of direct injury to the dorsal sensory branch of the ulnar nerve caused by arthroscopic repair of the triangular fibrocartilage complex. The dorsal sensory branch of the ulnar nerve was strangulated by one of the three pull-out sutures of the joint capsule, just ulnar to the extensor carpi ulnaris tendon. Pain and dysaesthesia of the ulnar side of the wrist was completely relieved after excision of the injured nerve segment. This complication can be avoided by careful exploration of the dorsal sensory branch of the ulnar nerve prior to suturing or passage of instruments during arthroscopy.

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“…This tension of the joint is achieved either by manual traction exerted by the assistant or by intraoperative mounting of a sterilizable traction device. Arthroscopy is performed either through the standard dorsal portals [40] or via a volar approach between the radiolunate and radioscaphocapitate ligaments [3]. Joint cleaning, extraction of blood clots as well as check of reduction are performed.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures

et al. 2004

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European Journal of Trauma Ab stractDuring the last years there have been considerable changes in the assessment and management of distal radius fractures. In many patients, conservative treatment has shown poor functional results, despite satisfactory radiologic findings. This is due to a remarkably high number of concomitant carpal lesions occurring together with distal intraarticular radius fractures. Using wrist arthroscopy in the acute management of these fractures, the intraarticular fracture pattern can be exactly evaluated and concomitant carpal lesions like tears of the intrinsic ligaments of the proximal carpal row, lesions of the triangular fibrocartilage complex and free intraarticular bodies can be diagnosed and treated at the same sitting.

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Anatomical and safety considerations in establishing portals used for wrist arthroscopy

Cited by 31 publications

References 5 publications

Results of Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tear With Exploration of Dorsal Sensory Branch of Ulnar Nerve

Results of Arthroscopic Repair of Peripheral Triangular Fibrocartilage Complex Tear With Exploration of Dorsal Sensory Branch of Ulnar Nerve

Injury of the Dorsal Sensory Branch of the Ulnar Nerve as a Complication of Arthroscopic Repair of the Triangular Fibrocartilage

Distal Radius Fractures

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