Intérêt thérapeutique de l'arthroscopie du poignet : à propos de 1000 cas

Abstract

Wrist arthroscopy is a relatively recent procedure because it was described in the 70's. During the first period of 80's it became an indisputable technique of diagnosis. Since the 90's many therapeutic procedure were described by several authors all over the world. This technique increase a lot the understanding of wrist pathologies and ameliorate significantly the results for patients. We report our experience about 1000 wrist arthroscopy between 1998 and 2005. The patients were always operated on outpatient basis under local regional anaesthesiology. The arm was laid on the table and the hand on in-line traction (5-7 kg). We used a 2.4 mm arthroscope, 30 degrees angled. The both joints, radiocarpal and midcarpal, were systematically explored. The small portals were not closed. In our experience, only 42 arthroscopies (4%) were without surgical procedure. We separated the indications in 7 chapters: 1) arthoscopic assistance for fractures treatment (distal radius and scaphoid: 7%; 2) TFCC tears (17%); 3) treatment of intrinsic ligaments tears (scapholunate and lunotriquetral: 21%); 4) ectomy (radial styloidectomy, wafer, carpal boss 13%); 5) resection of wrist ganglia (21%); 6) partial prosthesis (2,5%); 7) others techniques (arthrolysis, synovectomy 14,5%).