Hand Surgery

Wrist Arthroscopy

  • July 1, 2020
  • 2 minutes read

If you are suffering from wrist pain for no apparent reason, this procedure may reveal and solve the problem.

Wrist arthroscopy is a type of minimally invasive keyhole surgery. Through small incisions in the skin, a small telescope called an arthroscope is placed into the wrist. This allows direct visualisation of the insides of the joint. The surgeon can see the surface cartilage of the bones, assess the condition and stability of the ligaments holding the bones together, and diagnose the cause of any unresolved pain in the joint. Using small specialised instruments, treatment can be carried out immediately.

Your doctor may suggest a wrist arthroscopy if it is not clear what is causing your wrist pain after a thorough examination and the usual non-invasive investigations have been done. This usually includes X-rays and MRI of the wrist. Wrist arthroscopy might also be useful if your wrist pain persists despite non-surgical treatment after several months.

After diagnosing the cause of your wrist pain, wrist arthroscopy can be used to treat a number of conditions found at the same time.

Ligament tears

Ligaments are thick bands of fibrous tissue made of collagen that bind the bones of the wrist together. There are 28 intrinsic and extrinsic ligaments in the wrist and they provide stability and support to the joints. Ligaments are commonly torn after a fall on an outstretched hand. This results in persistent pain and weakness or a clicking sensation when moving the wrist. Arthroscopic surgery can trim and smoothen the frayed edges of the torn ligament and partially torn ligaments can be shrunk and tightened by heating and denaturing the collagen with lasers or radio frequency devices.

Triangular Fibrocartilage Complex (TFCC) tears

TFCC is the equivalent of the meniscus in the knee. It cushions and transmits force within the wrist. It is commonly torn after a fall on an outstretched hand or during unrestrained twisting actions of the wrist. This results in pain, a clicking sensation and limited forearm rotation. Arthroscopic surgery can trim part of the torn TFCC that causes a mechanical block to forearm rotation. Some TFCC tears can also be repaired arthroscopically using specialised sutures and instruments.

Wrist fractures

Wrist arthroscopy can be used to remove small fragments of bone that have broken off and lodged in the wrist joint after bony fractures of the wrist bones. It can also be used to visually inspect the cartilage of the joint for correct alignment of the broken pieces of bone during reduction when the fracture had extended into the wrist joint.

Ganglion cysts

Ganglion cysts are collections of fluid arising from a ligament in the wrist. Some surgeons prefer to treat a ganglion cyst by wrist arthroscopy. During this procedure, the stalk of the ganglion cyst can be removed and the ganglion cyst excised.

Wrist arthroscopy is less painful than open surgery. There is also less postoperative swelling and it generally results in faster functional recovery. Like any invasive surgical procedures, complications can arise but they are less common than in open surgery. The possible complications include infection, nerve, tendon and skin injuries, and compartmental syndrome. Although many procedures can be done using wrist arthroscopy nowadays, the open technique with longer incisions is still required for complicated wrist reconstruction. Your surgeon will be able to advise you on the most appropriate surgical technique to treat your condition.

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