Our Summary

This study focuses on a surgical technique called volar midcarpal arthroscopy, which involves making small incisions in the wrist to examine or treat joint issues. The researchers used five cadavers to study how to best perform this procedure without damaging important structures in the wrist.

They focused on two specific incision points (named VUMC and VRMC), and used a method called the “inside-out” technique. They then measured the distance from these incision points to important structures in the wrist, such as tendons, arteries, and nerves.

The results showed that when making the VUMC incision, it sometimes pierced a tendon and was quite close to an artery and a nerve. The VRMC incision also occasionally pierced a tendon and was very close to a major nerve.

This means surgeons need to be very careful when performing this procedure to avoid damaging these important structures, particularly the major nerve near the VRMC incision point.

FAQs

  1. What is volar midcarpal arthroscopy and why is it used?
  2. What are the potential risks associated with the VUMC and VRMC incision points during a volar midcarpal arthroscopy?
  3. How can surgeons avoid damaging important structures in the wrist during volar midcarpal arthroscopy?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient undergoing wrist arthroscopy is to ensure they are being treated by a skilled and experienced surgeon who is familiar with the anatomy of the wrist and can perform the procedure safely. It is also important for the patient to follow post-operative care instructions carefully to promote healing and prevent complications.

Suitable For

Patients who are typically recommended for wrist arthroscopy include those with:

  1. Persistent wrist pain or instability
  2. Cartilage tears or damage within the wrist joint
  3. Ligament injuries, such as a torn ligament in the wrist
  4. Ganglion cysts or other soft tissue masses in the wrist
  5. Fractures or bone spurs within the wrist joint
  6. Inflammatory conditions, such as arthritis, affecting the wrist joint

It is important for patients to consult with a healthcare provider to determine if wrist arthroscopy is the appropriate treatment option for their specific condition.

Timeline

Before wrist arthroscopy:

  1. Patient experiences wrist pain and/or stiffness.
  2. Patient consults with a doctor or specialist who recommends wrist arthroscopy.
  3. Pre-operative tests and evaluations are conducted to ensure the patient is a suitable candidate for the procedure.
  4. Surgical consent is obtained from the patient.
  5. Patient is given pre-operative instructions, including fasting guidelines and medication management.

After wrist arthroscopy:

  1. Patient undergoes the wrist arthroscopy procedure.
  2. Post-operative pain management and wound care are provided.
  3. Patient may experience swelling, bruising, and discomfort in the wrist.
  4. Physical therapy or rehabilitation may be recommended to aid in wrist recovery and regain strength and range of motion.
  5. Follow-up appointments are scheduled to monitor healing and address any concerns or complications.
  6. Patient gradually resumes normal activities and may experience improved wrist function and reduced pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about wrist arthroscopy include:

  1. What specific type of wrist arthroscopy procedure will be performed?
  2. What are the potential risks and complications associated with wrist arthroscopy?
  3. How experienced is the surgeon in performing wrist arthroscopy procedures?
  4. What is the expected recovery time and rehabilitation process following wrist arthroscopy?
  5. Are there any alternative treatment options available for my condition?
  6. How likely is it that important structures in the wrist, such as tendons, arteries, and nerves, could be damaged during the procedure?
  7. How will pain be managed during and after the procedure?
  8. What can I expect in terms of long-term outcomes and prognosis following wrist arthroscopy?
  9. How soon after the procedure can I return to normal activities and work?
  10. Are there any specific precautions or restrictions I should follow after wrist arthroscopy?

Reference

Authors: Gillis JA, Kakar S. Journal: J Hand Surg Am. 2019 Dec;44(12):1094.e1-1094.e6. doi: 10.1016/j.jhsa.2019.02.006. Epub 2019 Mar 20. PMID: 30902356