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A new technique of wrist arthroscopy to visualise instability

A new technique of wrist arthroscopy to visualise instability. J. Huracek*, J. Chomiak º, H. Troeger*. * Department for surgery of the hand and the peripheral nerve, University Hospital Basel, Switzerland. ° Clinic for orthopaedic surgery “Bulovka”, Prague, Czech Republic.

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A new technique of wrist arthroscopy to visualise instability

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  1. A new technique of wrist arthroscopy to visualise instability J. Huracek*, J. Chomiak º, H. Troeger* * Department for surgery of the hand and the peripheral nerve, University Hospital Basel, Switzerland ° Clinic for orthopaedic surgery “Bulovka”, Prague, Czech Republic

  2. wrist arthroscopy and instability • technique on wrist • technique on shoulder / knee • great extent of positioning • ligamentotaxis / palpation • no palmar approach • no pro- / suppination • no operation in succession

  3. wrist arthroscopy and instability • horizontal position • no distraction • intraarticular pression • up to150 mm Hg • hypomochlion • move instead of draw

  4. wrist arthroscopy and instability • prospective study of 30 patients • arthroscopy without distraction, followed by • conventional arthroscopy with 3 kg traction • standardised protocol • diagnostic sensitivity • quality of surgical procedures • complications

  5. wrist arthroscopy and instability • diagnoses involved 19 injuries, 11 degenerative diseases • 11 times therapeutic surgery 2 discus suture, 9 discus debridèment • mean age 37,1 years; follow-up 10,2 weeks

  6. wrist arthroscopy and instability • results with / without distraction: • same sensitivity (except for instability) • same specifity • surgical procedures not hindered • no complications (CTS) • followed-up till today : • 30 prospectively, 117 retrospectively

  7. wrist arthroscopy and instability arthroscopy of intercarpal space MCU

  8. wrist arthroscopy and instability arthroscopy of radiocarpal space total SL - rupture

  9. wrist arthroscopy and instability arthroscopy of radiocarpal space total SL - rupture with pathological RU-duction

  10. the “Basel” technique of wrist arthroscopy • less extent (positioning, fluoroscopy) • technically more difficult • dynamical assessment of ligamentous instability • direct proceed to open surgery (arthrotomy, distal radius fracture)

  11. outlook • intra-articular assessment before standard OP • new, combined arthroscopic-open procedures • assessment of acute trauma

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