|
Wrist arthroscopy (from the Greek άρθρωση, ''arthros'' "joint" and σκοπεῖν, ''skopein'' "to look or see") can be used to look inside the joint of the wrist. It is a minimally invasive technique which can be utilized for diagnostic purposes as well as for therapeutic interventions. Wrist arthroscopy has been used for diagnostic purposes since it was first introduced in 1979. However, it only became accepted as diagnostic tool around the mid-1980s. At that time, arthroscopy of the wrist was an innovative technique to determine whether a problem could be found in the wrist. A few years later, wrist arthroscopy could also be used as a therapeutic tool. == Procedure == Before surgery can be started, the patient has to be positioned in such a way that the wrist is stabilized. In order to do this, the patient has to be placed on the operating table with his or her face upward. The wrist of the arm on which will be operated on, has to be placed on a separate operating table on the side of the other operating table. To properly stabilize the wrist, the patient's elbow is flexed and the forearm is immobilized by using a traction apparatus. By using a traction apparatus, it will also become easier to insert the instruments. In general, 4.5-6.8 kilograms of traction is implemented with the aid of finger traps. The surgeon can either opt for nylon finger traps or for wire traps. In most cases, nylon finger traps will be preferred to wire traps, as nylon is a more resilient material and thus distributes the traction force to the skin more evenly. Usually, traction is applied to two fingers, namely the index finger and middle finger. Sometimes it may be necessary to more evenly distribute the traction force on the skin, as the patient's skin may be too fragile or atrophic. The traction brought about by the traction apparatus is then applied to three or even four fingers.〔 The surgeon can either opt for dry arthroscopy or for wet arthroscopy. When performing a dry procedure the wrist can still, if necessary, be approached using open surgery. This may, for example, be required when a TFCC lesion is diagnosed. The latter is not possible when a wet procedure is performed, because the fluid that is used causes expansion of the tissue. To improve visualization within the wrist, an inflow irrigation system is used during surgery. Currently, several systems are available, such as gravity flow, a hand pump, large syringes, or a mechanical infusion pump. For irrigation, lactated Ringer’s solution is generally used. The characteristics of lactated Ringer’s solution are that it is physiological and rapidly absorbed. Moreover, the right equipment must be available to finish a complete diagnostic arthroscopy, as well as to perform various operative procedures. Complications of using an irrigation system is that fluid extravasation into the soft tissues of the forearm can result into a compartment syndrome.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Wrist arthroscopy」の詳細全文を読む スポンサード リンク
|