Many diseases can be diagnosed and treated with wrist arthroscopy.
Wrist arthroscopy is used in the cleaning of ganglion cysts and wrist inflammations, the grading and treatment of wrist calcifications, and the treatment of tears in the wrist meniscus structure called TFCC. It can be used in the repair of wrist ligament injuries, mostly in the S-L ligament, and in the treatment of fractures of the wrist bones and the resulting calcification.
The cameras and instruments used in wrist arthroscopy are smaller than those used in large joints such as the knee and shoulder. . The patient is laid on the operating table, preferably under armpit anesthesia, with the hand suspended on a special sling device. The wrist joint is entered with a camera and instruments, using 2-3 mm incisions, mostly on the back of the wrist. Depending on the type of surgery to be performed, the surgical procedure is performed dry or by inflating the joint with serum.
Main Surgeries Performed with Wrist Arthroscopy
Ganglion Cyst Removal
Ganglion cyst is a cystic cyst caused by herniation of the membrane of the joint or tendon sheaths. It is a swelling. It is more common in women. Although the cause of ganglion cyst is not exactly known, it is associated with anatomical defects or cystic erosions of the joint capsule and tendon sheaths. There is a ganglion cyst wall consisting of connective tissue and a dense, sticky, colorless and jelly-like fluid inside it. It is mostly on the back of the wrist and sometimes in the hand. It is seen on the inside of the wrist. The swelling is the size of a hazelnut.
If the ganglion cyst causes pain and limitation of movement due to mass effect in the joint, it should be removed.
The recently preferred approach in ganglion removal surgeries with wrist arthroscopy is dry, that is, watering the joint. The cyst is visualized by entering a camera through a 2 mm incision, and the wall and contents of the cyst are cleaned with instruments inserted through a second smaller incision, without damaging the surrounding important tissues. Recovery time with wrist arthroscopy is 3 days, and full recovery is on average 10 days.
TFCC Injury
The bone on the 5th finger side of the wrist, which supports the wrist bones and acts as a cushion. It is a backbone structure. It can also be defined as the meniscus of the wrist. It plays an important role in grasping the hand and turning movements of the forearm.
TFCC tears can occur acutely, mostly by falling on the open hand with the wrist turned. Chronic TFCC tears are wear disorders that develop due to age and other rheumatic diseases.
The main symptoms of TFCC injuries are pain and swelling on the 5th finger side of the wrist, decrease in grip strength and painful clicking with wrist movement.
The first option in the treatment of TFCC injuries is always non-surgical methods. Applying a cast or wrist brace, anti-inflammatory medication or cortisone injection may be performed. Surgical treatment is considered in cases of pain that does not respond to these treatments and continues for at least 3 months.
After imaging the tear with a camera, repair is made through a mini incision made on the 5th finger of the wrist. Following the suturing of the tear, the wrist is kept in a plaster-splint for 6 weeks.
Wrist Ligament Injuries
There are 8 small wrist bones between the forearm and metacarpal bones. These bones are formed by a ball-bearing-like mechanism. Allows wrist movement. There are ligaments that hold these bones together. Ligament injuries, with or without fractures, may occur following various traumas, most commonly falling on an open hand. If these ligament injuries are not treated in time, the bones are displaced and the entire mechanism is damaged, such as the disintegration of the ball bearing. In other words, calcification occurs in the wrist in the future.
The most injured ligament is the S-L ligament that connects the scaphoid and lunate bones. It is typical to experience pain at the mid-level of the back of the wrist when the wrist is forced backwards. Examination and, if possible, an MRI scan with high Tesla power are diagnostic.
If the degree of injury is not too high in the treatment, the first option is to follow up with conservative methods such as plaster cast and bracelet for 6 weeks and then apply physical therapy. If conservative treatment does not yield results, if the degree of injury is greater and the distance between the bones is not widened, it is possible to treat it with a closed method, that is, wrist arthroscopy. Wrist arthroscopy After the surgery, a cast and splint is applied for 6 weeks. After the surgery, the time to do daily activities without pain is 3 months, and the time to return to active sports is 6 months.
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