Isolated Arthroscopic Radial Styloidectomy: The Three-Portal Approach

Abstract

Background The current gold-standard technique for radial styloidectomy is arthroscopic. The use of only two dorsal portals may not allow a crystal-clear view of the dorsal arthritic rim of the radius because of the dorsal capsule synovitis.

Objectives To propose a new technique for isolated arthroscopic radial styloidectomy. The addition of a volar radial portal and a sequential procedure are presented.

Patients and Methods Two trochars for alternatively viewing from volar radial or 3–4 are used. A 1–2 portal is used for instrumentation with a motorized burr. We have been using the three-portal technique in 34 cases (26 isolated).

Results This modification of the classic arthroscopic radial styloidectomy is technically easy and the view of the dorsal rim of the radius provides a clear definition and treatment of the dorso-radial arthritic pathology.

Conclusions The authors recommend this technical trick to perform an easy and comprehensive isolated palliative or curative arthroscopic radial styloidectomy.

Keywords

radial styloidectomy - scapholunate advanced collapse - scaphoid nonunion advanced collapse - wrist arthritis - wrist arthroscopy

• References

• 1 Barnard L, Stubbins SG. Styloidectomy of the radius in the surgical treatment of nonunion of the carpal navicular; a preliminary report. J Bone Joint Surg Am 1948; 30A (01) 98-102
• 2 Kalainov DM, Cohen MSweet S. Radial styloidectomy. In: Geissler WB. , ed. Wrist Arthroscopy. New York, NY: Springer-Verlag; 2005: 134-138
• 3 Nakamura T, Cooney III WP, Lui WH. , et al. Radial styloidectomy: a biomechanical study on stability of the wrist joint. J Hand Surg Am 2001; 26 (01) 85-93
• 4 Siegel DB, Gelberman RH. Radial styloidectomy: an anatomical study with special reference to radiocarpal intracapsular ligamentous morphology. J Hand Surg Am 1991; 16 (01) 40-44
• 5 Yao J, Osterman AL. Arthroscopic techniques for wrist arthritis (radial styloidectomy and proximal pole hamate excisions). Hand Clin 2005; 21 (04) 519-526
• 6 Baratz ME. Radial styloidectomy. In: Baratz ME, Rosenwasser MP, Adams BD, Kozin SH. , eds. Wrist Surgery. Tricks of the Trade. New York, NY: Thieme; 2006: 128
• 7 Gill LE, Chhabra AB. The role of arthroscopic evaluation and debridement in wrist arthritis. In: Chhabra AB, Isaaca J. , eds. Arthritis and Arthroplasty of the Hand, Wrist and Elbow. Philadelphis, PA: Saunders-Elsevier; 2015: 15
• 8 Levadoux M, Cognet JM. [Arthroscopic styloidectomy]. Chir Main 2006; 25 (Suppl. 01) S197-S201
• 9 Mathoulin C. Arthroscopic radial styloidectomy. In: Wrist Arthroscopy Techniques. Stuttgart, Germany: Thieme; 2015: 33-35
• 10 Del Pinal F. Technical tips for (dry) arthroscopic reduction and internal fixation of DRF. JHSA 2011; 36A (10) 1694-1705
• 11 Herzberg G. Perilunate injuries, non dislocated (PLIND). J Wrist Surg 2013; 2 (04) 337-345
• 12 Slutsky DJ. Volar portals in wrist arthroscopy. J Am Soc Surg Hand 2002; 2: 225-232
• 13 Tham S, Coleman S, Gilpin D. An anterior portal for wrist arthroscopy. Anatomical study and case reports. J Hand Surg [Br] 1999; 24 (04) 445-447
• 14 Slutsky DJ. Wrist arthroscopy through a volar radial portal. Arthroscopy 2002; 18 (06) 624-630
• 15 Ruch DS, Chang DS, Poehling GG. The arthroscopic treatment of avascular necrosis of the proximal pole following scaphoid nonunion. Arthroscopy 1998; 14 (07) 747-752