The evolving role of wrist arthroscopy.

IF 1.6
Francisco Del Piñal
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Abstract

Wrist arthroscopy is a valuable tool in hand surgery. However, as with every tool, its use must be executed by the right hands with the right training and right instrumentation. In this article, four papers on arthroscopy were examined for their contribution to the literature and to reflect on the evolving role of arthroscopy in hand surgery. The dorsal sensory branch of the ulnar nerve remains vulnerable with the placements of ulnar portals. Building from previous work, a 'nerve density' concept was presented, as it relates to wrist pronation and supination. The advent of arthroscopy has allowed the closed repair of triangular fibrocartilage complex injuries with better healing potential. Well-defined anatomical landmarks allow more precise placement of suture materials which need to be used judiciously to avoid further injuries. Likewise, scaphoid non-union can be successfully treated as a closed procedure using arthroscopy. A surgeon's learning journey was revealed as a change in practice to obtain the best results. Perilunate injuries can also be treated arthroscopically, but the problems related to bone-ligament interface healing remain unsolved. These publications reflect the increasing usage of this valuable tool and the lessons learnt would further optimize results and avoid pitfalls. Major breakthroughs in wrist arthroscopy in the near future may be obtained through better training and education. Research into the healing of the bone-ligament interface would allow more judicious use of implants.

腕部关节镜检查作用的演变。
腕部关节镜检查在手部手术中是一种很有价值的工具。然而,与每一个工具一样,它的使用必须由正确的训练和正确的仪器正确的手执行。在这篇文章中,四篇关于关节镜的论文被检查了他们对文献的贡献,并反映了关节镜在手外科手术中的作用。尺神经的背侧感觉分支在尺神经门的位置仍然是脆弱的。基于先前的工作,提出了“神经密度”的概念,因为它与手腕旋前和旋后有关。关节镜的出现使得三角形纤维软骨复合体损伤的闭合修复具有更好的愈合潜力。明确的解剖标志允许更精确地放置缝合材料,需要明智地使用,以避免进一步的伤害。同样,舟状骨不连也可以通过关节镜手术成功治疗。一位外科医生的学习之旅揭示了在实践中获得最佳结果的变化。月骨周围损伤也可以通过关节镜治疗,但与骨-韧带界面愈合有关的问题仍未解决。这些出版物反映了越来越多地使用这一宝贵的工具,所吸取的经验教训将进一步优化结果并避免陷阱。通过更好的训练和教育,在不久的将来腕部关节镜的重大突破可能会获得。对骨-韧带界面愈合的研究将允许更明智地使用植入物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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