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Handchir Mikrochir Plast Chir 2020; 52(05): 441-446
DOI: 10.1055/a-1239-4006
Originalarbeit

Dry arthroscopic 4-corner arthrodesis and other refinements to stay within a tourniquet time

„Trockene“ arthroskopische 4-Corner-Arthrodese und andere technische Verfeinerungen um in der Blutleerezeit zu bleiben
Jaime S. Ruas 
1   Instituto de Cirugía Plástica y de la Mano, Private practice, Madrid & Santander, Spain
2   Hospital Mutua Montañesa, Santander, Spain
,
Francisco del Pinal
1   Instituto de Cirugía Plástica y de la Mano, Private practice, Madrid & Santander, Spain
2   Hospital Mutua Montañesa, Santander, Spain
,
Raquel Mazarrasa
1   Instituto de Cirugía Plástica y de la Mano, Private practice, Madrid & Santander, Spain
2   Hospital Mutua Montañesa, Santander, Spain
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Abstract

4-corner arthrodesis is a widely implanted procedure to treat degenerated joints in the wrist such as SLAC and SNAC stage II and III. Arthroscopy in combination with headless cannulated screws, permits reproducing the same intervention with the advantages of a minimally invasive surgery. This technique has already been published in the past supported by the early experience in this new exciting field. The purpose of this paper is to present new technical refinements collected over the years in order to speed up the surgery while obtaining optimum results. In this paper we also present extreme scenarios solved by combining the scope with cannulated screws.

Zusammenfassung

Die mediokarpale Teilversteifung unter Resektion des Skaphoids ist eine gut etablierte Behandlung degenerativer Veränderungen des Handgelenkes beim karpalen Kollaps Stadium II und III bei SLAC- und SNAC-wrist. Die Kombination von Arthroskopie und Verwendung von kanülierten kopflosen Schrauben macht es möglich, den Eingriff minimal invasiv durchzuführen. Hierüber wurde bereits in der Vergangenheit berichtet. In dieser Arbeit präsentieren wir über Jahre entwickelte Verfeinerungen der Operationstechnik, deren Ziel es ist, die Operationszeit zu verkürzen und die Ergebnisse zu optimieren. Zugleich stellen wir an extremen Fallbeispielen dar, welche Möglichkeiten die Kombination von Arthroskopie mit kanülierten Schrauben bietet.

Key words

Dry arthroscopy - 4-Corner arthrodesis - partial wrist arthrodesis - total wrist arthrodesis

Schlüsselwörter

Trockene Arthroskopie - 4-Corner-Arthrodese - Handgelenksteilversteifung - Handgelenksvollversteifung


Publication History

Received: 02 August 2020

Accepted: 11 August 2020

Article published online:
29 September 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literature

  • 1 del Piñal F, García-Bernal FJ, Pisani D. et al. Dry arthroscopy of the wrist: Surgical technique. J Hand Surg Am 2007; 32: 119-123
    CrossrefPubMedSearch in Google Scholar
  • 2 del Piñal F. Dry arthroscopy and its applications. Hand Clin 2011; 27: 335-345
    PubMedSearch in Google Scholar
  • 3 del Piñal F, Klausmeyer M, Thams C. et al. Early experience with (dry) arthroscopic 4-corner arthrodesis: From a 4-hour operation to a tourniquet time. J Hand Surg Am 2012; 37: 2389-2399
    CrossrefPubMedSearch in Google Scholar
  • 4 del Piñal F, Tandioy-Delgado F. (Dry) arthroscopic partial wrist arthrodesis: Tips and tricks. Handchir Mikrochir Plast Chir 2014; 46: 300-306
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 del Piñal F, García-Bernal FJ, Delgado J. et al. Correction of malunited intra-articular distal radius fractures with an inside-out osteotomy technique. J Hand Surg Am 2006; 31: 1029-1034
    CrossrefPubMedSearch in Google Scholar
  • 6 del Piñal F. Arthroscopy: Some Dos and Don’ts. In del Piñal F. (ed.) Arthroscopic management of distal radius fractures. New York: Thieme; 2018: 51-72
    Search in Google Scholar
  • 7 Mühldorfer-Fodor M, Ha HP, Hohendorff B. et al. Results after radioscapholunate arthrodesis with or without resection of the distal scaphoid pole. J Hand Surg Am 2012; 37: 2233-2239
    CrossrefPubMedSearch in Google Scholar
  • 8 del Piñal F, Moraleda E, Rúas JS. et al. Minimally invasive fixation of fractures of the phalanges and metacarpals with intramedullary cannulated headless compression screws. J Hand Surg Am 2015; 40: 692-700
    CrossrefPubMedSearch in Google Scholar
  • 9 Ho PC. Arthroscopic partial wrist fusion. Tech Hand Up Extrem Surg 2008; 12: 242-265
    CrossrefPubMedSearch in Google Scholar
  • 10 Nagy L, Büchler U. AO-wrist arthrodesis: with and without arthrodesis of the third carpometacarpal joint. J Hand Surg Am 2002; 27: 940-947
    CrossrefPubMedSearch in Google Scholar