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Portals and Methodology

  • David J. SlutskyEmail author
Chapter
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Abstract

Wrist arthroscopy has steadily grown from a mostly diagnostic tool to a valuable adjunctive procedure in the treatment of distal radius fractures. Many studies have demonstrated the superiority of an arthroscopic-assisted reduction of a displaced intraarticular fracture over a fluoroscopic reduction. A systematic approach and a thorough understanding of the topographical and internal anatomy of the wrist are integral to minimizing complications while maximizing the chances for a successful outcome. The following chapter will discuss the portal placement and methodology of wrist arthroscopy along with its application in the treatment of distal radius fractures.

Keywords

Distal Radius Fracture Flexor Carpus Radialis Extensor Digitorum Communis Extensor Carpus Ulnaris Radial Styloid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Abrams RA, Petersen M, Botte MJ. Arthroscopic portals of the wrist: an anatomic study. J Hand Surg [Am]. 1994;19: 940–4CrossRefGoogle Scholar
  2. 2.
    Atzei A, Rizzo A, Luchetti R, Fairplay T. Arthroscopic foveal repair of triangular fibrocartilage complex peripheral lesion with distal radioulnar joint instability. Tech Hand Up Extrem Surg. 2008;12:226–35CrossRefPubMedGoogle Scholar
  3. 3.
    Balogh B, Valencak J, Vesely M, Flammer M, Gruber H, Piza-Katzer H. The nerve of Henle: an anatomic and immunohistochemical study. J Hand Surg [Am]. 1999;24: 1103–8CrossRefGoogle Scholar
  4. 4.
    Botte MJ, Cohen MS, Lavernia CJ, von Schroeder HP, Gellman H, Zinberg EM. The dorsal branch of the ulnar nerve: an anatomic study. J Hand Surg [Am]. 1990;15: 603–7CrossRefGoogle Scholar
  5. 5.
    DaSilva MF, Moore DC, Weiss AP, Akelman E, Sikirica M. Anatomy of the palmar cutaneous branch of the median nerve: clinical significance. J Hand Surg [Am]. 1996; 21: 639–43CrossRefGoogle Scholar
  6. 6.
    del Piñal F, Garcia-Bernal FJ, Pisani D, Regalado J, Ayala H, Studer A. Dry arthroscopy of the wrist: surgical technique. J Hand Surg [Am]. 2007;32:119–23CrossRefGoogle Scholar
  7. 7.
    Dicpinigaitis P, Wolinsky P, Hiebert R, Egol K, Koval K, Tejwani N. Can external fixation maintain reduction after distal radius fractures? J Trauma. 2004;57:845–50CrossRefPubMedGoogle Scholar
  8. 8.
    Doi K, Hattori Y, Otsuka K, Abe Y, Yamamoto H. Intra-articular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg Am. 1999; 81:1093–110PubMedGoogle Scholar
  9. 9.
    Gelberman RH, Panagis JS, Taleisnik J, Baumgaertner M. The arterial anatomy of the human carpus. Part I: the extraosseous vascularity. J Hand Surg [Am]. 1983;8: 367–75Google Scholar
  10. 10.
    Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg. 1993;92:1380–4PubMedGoogle Scholar
  11. 11.
    Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg [Br]. 1997;22:638–43Google Scholar
  12. 12.
    Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg [Am]. 2000;25:464–8CrossRefGoogle Scholar
  13. 13.
    Mackinnon SE, Dellon AL. The overlap pattern of the lateral antebrachial cutaneous nerve and the superficial branch of the radial nerve. J Hand Surg [Am]. 1985;10:522–6Google Scholar
  14. 14.
    Martin CH, Seiler JG III, Lesesne JS. The cutaneous ­innervation of the palm: an anatomic study of the ulnar and median nerves. J Hand Surg [Am]. 1996;21:634–8CrossRefGoogle Scholar
  15. 15.
    McCabe SJ, Kleinert JM. The nerve of Henle. J Hand Surg [Am]. 1990;15:784–8CrossRefGoogle Scholar
  16. 16.
    Mehta JA, Bain GI, Heptinstall RJ. Anatomical reduction of intra-articular fractures of the distal radius. An arthroscopically-assisted approach. J Bone Joint Surg Br. 2000;82:79–86CrossRefPubMedGoogle Scholar
  17. 17.
    Omokawa S, Ryu J, Tang JB, Han J. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg. 1997;99:116–21CrossRefPubMedGoogle Scholar
  18. 18.
    Ruch DS, Vallee J, Poehling GG, Smith BP, Kuzma GR. Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures. Arthroscopy. 2004;20:225–30CrossRefPubMedGoogle Scholar
  19. 19.
    Slutsky D. Wrist arthroscopy: portals and procedures. In: Trumble T (ed). Hand surgery update IV. American Society for Surgery of the Hand; 2007Google Scholar
  20. 20.
    Slutsky DJ. Wrist arthroscopy through a volar radial portal. Arthroscopy. 2002;18:624–30CrossRefPubMedGoogle Scholar
  21. 21.
    Slutsky DJ. Clinical applications of volar portals in wrist arthroscopy. Tech Hand Up Extrem Surg. 2004;8: 229–38CrossRefPubMedGoogle Scholar
  22. 22.
    Slutsky DJ. The use of a volar ulnar portal in wrist arthroscopy. Arthroscopy. 2004;20:158–63CrossRefPubMedGoogle Scholar
  23. 23.
    Slutsky DJ. Wrist arthroscopy portals. In: Slutsky DJ, Nagle DJ, editors. Techniques in hand and wrist arthroscopy. Amsterdam: Elsevier; 2007Google Scholar
  24. 24.
    Steinberg BD, Plancher KD, Idler RS. Percutaneous Kirschner wire fixation through the snuff box: an anatomic study. J Hand Surg [Am]. 1995;20:57–62CrossRefGoogle Scholar
  25. 25.
    Tay SC, Tomita K, Berger RA. The “ulnar fovea sign” for defining ulnar wrist pain: an analysis of sensitivity and specificity. J Hand Surg [Am]. 2007;32:438–44CrossRefGoogle Scholar
  26. 26.
    Trumble TE, Gilbert M, Vedder N. Isolated tears of the triangular fibrocartilage: management by early arthroscopic repair. J Hand Surg [Am]. 1997;22:57–65CrossRefGoogle Scholar
  27. 27.
    Wiesler ER, Chloros GD, Lucas RM, Kuzma GR. Arthroscopic management of volar lunate facet fractures of the distal radius. Tech Hand Up Extrem Surg. 2006;10: 139–44.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.The Hand & Wrist InstituteTorranceUSA

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