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Nội soi khớp cổ tay: Nguyên tắc và các ứng dụng lâm sàng

Tóm tắt Với sự phát triển của thiết bị tốt hơn và nhỏ hơn, nội soi khớp cổ tay cung cấp các lợi ích tương tự đạt được với nội soi khớp gối, vai, khuỷu tay, không chỉ thông tin chẩn đoán nhưng cũng là một lựa chọn điều trị. Kỹ thuật tiêu chuẩn hóa thực hiện nội soi khớp cổ tay đã được phát triển | Wrist Arthroscopy Principles and Clinical Applications Ranjan Gupta MD David J. Bozentka MD and A. Lee Osterman MD Abstract With the development of better and smaller equipment arthroscopy of the wrist offers the same benefits achievable with arthroscopy of the knee shoulder or elbow not only diagnostic information but also a therapeutic option. Standardized techniques of performing wrist arthroscopy have been developed to evaluate and treat various wrist disorders such as lesions of the triangular fibrocartilage complex intra-articular distal radius fractures and scaphoid fractures. Arthroscopy is now performed in the treatment of dorsal-wrist ganglion cysts and interosseous ligament disruptions as well as for bone excisions such as radial styloidectomy distal ulnar excision wafer procedure and proximal-row carpectomy. Compared with open techniques arthroscopic procedures such as repair of the triangular fibrocartilage complex demonstrate better results and improved localization of the injury with a low complication rate. In addition arthroscopic procedures involve less surgical dissection less postoperative pain a shorter recovery time and an earlier return to work for the patient. J Am Acad Orthop Surg 2001 9 200-209 Although surgical arthroscopy had been utilized earlier in larger joints it was not until 1985 that standardized portals and downsized equipment were developed to make it more appropriate to wrist anato-my.1 Over the past 15 years the technique of wrist arthroscopy has been refined to become a valuable tool for both the diagnosis and the treatment of wrist problems. Wrist arthroscopy provides the ability to directly view the chondral surfaces of the carpus the triangular fibro-cartilage complex TFCC and the ligamentous structures of the wrist. Role in Diagnosis and Treatment A careful history and physical examination are prerequisites before using wrist arthroscopy for either diagnosis or treatment. As the wrist is composed of eight carpal bones 27