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腕关节镜检查:干式关节镜探查的基本技巧

WRIST ARTHROSCOPY: BASIC TIPS FOR DRY ARTHROSCOPIC EXPLORATION.

作者信息

Pinto Henrique DE Barros, Oliveira Suzilaine Ramos DE, Pereira Flavia Curvo, Mazzer Nilton

机构信息

. Hospital Federal da Lagoa, Rio de Janeiro, RJ, Brazil.

. Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2017 Nov-Dec;25(6):291-294. doi: 10.1590/1413-785220172506160670.

Abstract

OBJECTIVE

This article provides details and tips on the dry arthroscopic technique, based on our experience and its clinical applications.

METHOD

The technique was applied to 65 patients (33 men and 32 women) aged between 20 and 62 years (average of 35.4 years) for treating: synovial cyst resection, scapholunate ligament injury repair, ulnocarpal impact correction, triangular fibrocartilage injury repair, and assisted reduction of distal radius fractures.

RESULTS

A minimally invasive intra-articular evaluation has been observed as a benefit, with low infection rate, small scars, and high rates of early recovery, without affecting intra-articular fluid use, reducing the risk of compartment syndrome and infiltrated soft tissues, in the case of need for associated open surgery. As for the difficulties, we report the surgeon's view, which is commonly prevented by optical blurring or debris that hit the lens, and the need for radiofrequency care, since the heat generated is dissipated with greater difficulty than in the classical technique.

CONCLUSION

Dry arthroscopy emerges as an effective choice to treat wrist pathologies, however, deep knowledge and ease with the classical technique, as well as a learning curve, are key to obtain a good outcome.

摘要

目的

本文根据我们的经验及其临床应用,提供有关干式关节镜技术的详细信息和技巧。

方法

该技术应用于65例年龄在20至62岁(平均35.4岁)之间的患者(33名男性和32名女性),用于治疗:滑膜囊肿切除、舟月韧带损伤修复、尺腕撞击矫正、三角纤维软骨损伤修复以及桡骨远端骨折的辅助复位。

结果

已观察到微创关节内评估具有益处,感染率低、疤痕小、早期恢复率高,在需要进行相关开放手术的情况下,不影响关节内液体的使用,降低了骨筋膜室综合征和软组织浸润的风险。至于困难之处,我们报告了外科医生的观点,即通常会因镜头模糊或碎片撞击镜头而受阻,并且需要注意射频,因为产生的热量比传统技术更难消散。

结论

干式关节镜检查是治疗腕部疾病的有效选择,然而,对传统技术的深入了解和熟练掌握以及学习曲线,是获得良好结果的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/5782867/34cbee7b698e/1413-7852-aob-25-06-00291-gf1.jpg

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