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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2023; 51(01): e048-e055
DOI: 10.1055/s-0043-1769605
Surgical Technique

Arthroscopy and Tenoscopy in the Treatment of 6th Compartment Tenosynovitis: Technical Description and Series of Patients

Article in several languages: español | English
Ricardo Kaempf de Oliveira
1   Departamento de Cirugía de la Mano, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
João Pedro Farina Brunelli
1   Departamento de Cirugía de la Mano, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
,
Márcio Aita
3   Departamento de Cirugía de la Mano, Faculdade de Medicina do ABC, Santo André, Brasil
,
Pedro J. Delgado
4   Departamento de Cirugía de la Mano, Unidad de Cirugía de la Mano, Hospital Universitário Madrid Montepríncipe, Universidade CEU San Pablo, Boadilla del Monte, Madri, Espanha
,
Elisa De Torres-De Torres
5   Departamento de Ortopedia y Traumatología, Unidad de Cirugía de la Mano, Hospital Universitario de Móstoles, Madrid, Spain
,
Fernando Corella
2   Departamento de Cirugía, Unidad de Cirugía de la Mano, Hospital Universitario Quirónsalud Madrid, Universidad Complutense de Madrid, Madrid, Spain
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Declaration of Funding This study did not receive any financial support for developing this work.
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Abstract

We call tenoscopy the procedure where an endoscopic approach to tendon sheaths is performed. It has already been described for the treatment of ankle, elbow, shoulder, wrist, and hand disorders. We have treated with tenoscopy a series of eight wrists in six patients with chronic inflammatory processes of the sixth extensor compartment of the wrist with no improvement with initial conservative treatment. The procedure begins with an arthroscopy of the radiocarpal and midcarpal spaces to rule out other intra-articular causes of ulnar-sided pain in the wrist. Then, through the 6R portal, the capsule, and the deep portion of the sheath of the extensor carpi ulnaris are resected, gaining access to the inside aspect of the sixth compartment. With the full view of the inner sixth compartment, a specific portal is created for the extensor carpi ulnaris located two centimeters proximal to the joint. Then a wide synovectomy of the compartment is performed with a shaver, both proximal and distal to the joint. The dorsal sensitive branch of the ulnar nerve remains safe throughout the procedure. We have performed a tenoscopy of the sixth extensor compartment in eight wrists of six patients who had failed conservative treatment and obtained great improvement of symptoms with the procedure, with no serious complications or lesion recurrence. Tenoscopy of the extensor carpi ulnaris allows synovectomy of the sixth extensor compartment, preserving the extensor retinaculum. With a minimally invasive approach, this procedure causes less local damage to soft tissues, with less scar tissue formation when compared with classic open procedures. By using a clear view of the compartment through tenoscopy, the risk of adhesions and injury to the ulnar extensor tendons is decreased.

Keywords

wrist pain - extensor carpi ulnaris - tenosynovitis - wrist ulnar-sided pain - arthroscopy portals - wrist arthroscopy complication

Declaration of Ethical Approval

The present study was submitted and approved by the Ethics Committee of our Institution.


Informed Consent Statement

There is no information (names, initials, hospital identification numbers, or photographs) in the submitted manuscript that could be used to identify the patients.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with institutional and/or national research committee ethical standards and the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards.




Publication History

Received: 15 October 2022

Accepted: 07 March 2023

Article published online:
07 June 2023

© 2023. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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