Löw S, Herold A, Eingartner C
Sektion Handchirurgie, Klinik für Orthopädie und Unfallchirurgie, Caritas-Krankenhaus, Uhlandstr. 7, 97980, Bad Mergentheim, Deutschland,
Oper Orthop Traumatol. 2014 Dec;26(6):539-46. doi: 10.1007/s00064-014-0311-6. Epub 2014 Dec 3.
Minimally invasive approach to the wrist in order to diagnose and treat different wrist pathologies.
Diagnosis of unclear chronic pain syndromes, cartilage status, intra-articular ligament structures as well as post-traumatic and inflammatory conditions of the wrist. Treatment of ulnar impaction syndrome, dorsal ganglia and also in fracture treatment and various different wrist interventions.
Soft tissue infections around the wrist, severe scarring may impede access to the joint.
Supine position with the forearm upright and in neutral position, the elbow flexed by 90°, axial traction of 3-4 kg. Superficial stab incision, blunt preparation through joint capsule, insertion of optic through 3-4 portal and probe through 4-5 portal, and radial and ulnar midcarpal portals, respectively. Either sodium chloride, CO2 or air is used as arthroscopy medium. Diagnostic round with standardized examination of all parts of the joint. Standardized written and high quality photo and/or video documentation to facilitate understandability of the findings.
Forearm cast for 1 week, limited load for 2 more weeks, then load is increased to normal.
采用微创方法治疗手腕，以诊断和治疗不同的手腕病变。
诊断不明的慢性疼痛综合征、软骨状况、关节内韧带结构以及手腕的创伤后和炎症性疾病。治疗尺骨撞击综合征、背侧腱鞘囊肿，也用于骨折治疗和各种不同的手腕手术。
手腕周围软组织感染，严重瘢痕可能妨碍进入关节。
仰卧位，前臂伸直并处于中立位，肘部屈曲90°，轴向牵引3-4千克。做一个浅表刺切口，钝性分离通过关节囊，通过3-4号入口插入关节镜，通过4-5号入口插入探针，分别通过桡侧和尺侧腕中入口。使用氯化钠、二氧化碳或空气作为关节镜检查介质。进行诊断性检查，对关节所有部位进行标准化检查。进行标准化的书面记录以及高质量的照片和/或视频记录，以方便理解检查结果。
前臂石膏固定1周，再限制负重2周，然后逐渐增加负重至正常。
