Dry DRUJ Arthroscopy.

Abstract

The first wrist arthroscopy report was published in 1979 by Chen.[1] Wrist arthroscopy was introduced mainly for diagnosis purposes in the earlier 80s, and then, arthroscopic “-ectomy” surgeries became popular in mid-80s and earlier 90s. Approximately, 30 years have passed since then, and many technological innovations along with advances in anatomical understanding and surgical techniques have been achieved. Especially, for triangular fibrocartilage complex (TFCC) lesions, the importance of fovea as the attaching area of the radioulnar ligament (RUL) has been recognized; however, the conventional radiocarpal arthroscopy cannot reveal the fovea area if there is no tear in the triangular fibrocartilage. The distal radioulnar joint (DRUJ) arthroscopy plays an important role in the diagnosis of the avulsion of the RUL and arthroscopic transosseous repair of the RUL (TFCC). DRUJ arthroscopy has been hardly reported in the literature[2] [3] because people may consider it technically difficult to perform. The technique of the DRUJ arthroscopy is quite simple and easy; furthermore, I have scoped DRUJ in every TFCC injury case in these 10 years and have found that DRUJ arthroscopic findings are essential for decision-making of TFCC repairs, such as arthroscopic repair, open repair, reconstruction using extensor carpi ulnaris half-slip tendon, or ulnar shortening. Without DRUJ arthroscopy, I cannot properly treat my TFCC injury patients.