Falcochio Diego Figueira, Brunelli João Pedro Farina
Departamento de Ortopedia e Traumatologia, Serviço de Cirurgia da Mão e Microcirurgia, Santa Casa de Misericórdia, São Paulo, Brasil.
Rev Bras Ortop (Sao Paulo). 2022 May 27;57(2):348-350. doi: 10.1055/s-0041-1726073. eCollection 2022 Apr.
Arthroscopy-assisted partial wrist-fusion techniques are becoming more popular nowadays. It became clearer that avoiding the violation of important ligament and tendinous structures - which is impossible when using the classic open techniques - enables a more biological approach, which is essential for faster healing and improvement in function. We describe the use of the triquetrum-hamate (TH) portal, which is seldomly applied in routine arthroscopic techniques for hand and wrist surgery, as an accessory portal to better perform anterior midcarpal debridement in four-corner fusion. This trick enables an almost complete anterior resection of the capitate and hamate chondral surfaces, increasing the subchondral osseous contact in the midcarpal joint after fixation, thus leading to higher consolidation rates.
如今，关节镜辅助下的部分腕关节融合技术越来越受欢迎。越来越明显的是，避免侵犯重要的韧带和肌腱结构——这在使用传统开放技术时是不可能的——能够采用更符合生物学的方法，这对于更快愈合和功能改善至关重要。我们描述了使用三角骨-钩骨（TH）通道，该通道在手部和腕部手术的常规关节镜技术中很少应用，作为辅助通道，以便在四角融合术中更好地进行腕中关节清创。这个技巧能够几乎完全切除头状骨和钩骨的软骨表面，增加固定后腕中关节的软骨下骨接触，从而提高愈合率。
