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Use of Arthroscopy in

Upper Limb Surgery

in stiff elbows to regain movement,

excise radial head, synovectomy and

arthroscopic release of tennis elbow

and related soft tissue pathologies.

(See Fig. 2)

WRIST SURGERY

Wrist arthroscopy is a developing and

useful technique. With limited morbidity,

it permits a substantial number of

technical procedures in a range of

areas, from fractures to the treatment

of ganglions. It is a useful modality in

diagnosing some of the more difficult

wrist conditions that are not otherwise

easily identifiable by imaging modalities.

It is used in staging and grading of wrist

pathologies which can alter the final

management pathway. It is often used

in traumatic injuries as in wrist and

scaphoid fractures. It can be used in

treating wrist ligament injuries including

ligament reconstructions and repair

of the wrist meniscal (TFC) injuries.

Additionally, treatment of wrist arthritis

can be carried out. (See Fig. 3)

HAND SURGERY

In hand surgery, the use of

arthroscopic techniques is still in

early stages and less developed.

However, it is already used in

treatment and assessment of base

of thumb arthritis, in particular in

early stages where conservative

measures have failed and the

patients are too young for more

aggressive treatment options.

With improved techniques, camera

systems and equipments, previously

difficult procedures are now possible

SHOULDER SURGERY

Arthroscopic shoulder surgery is one

of the most common, successful and

safe orthopaedic surgical procedures

undertaken. Arthroscopic subacromial

decompression is very successful

in relieving the pain of rotator cuff

tendonitis and allowing a return to

daily activities and sports. The recovery

is usually rapid and incidence of any

post-operative complication is low.

Arthroscopy is also used in performing

rotator cuff repairs, debridement of

calcific tendonitis, stabilisations, capsular

release for chronic adhesive capsulitis

(frozen shoulder), acromioclavicular

joint stabilisation for traumatic

dislocations and debridement of

degenerative and septic joints.

(See Fig. 1)

ELBOW SURGERY

In the elbow joint, the technique

is now established and it is feasible

to remove loose bodies, deride the

degenerative joint including removal of

osteophytes, perform a capsular release

Fig. 1

A completed arthroscopic rotator

cuff repair.

Fig. 3

Midcarpal view of a scaphoid

non-union with the associated

chondral damage.

Fig. 2

A loose body in the elbow joint.

Upper Limb Surgery

TEN

Upper Limb Surgery

With increasing use of arthroscopy in orthopaedic surgery over the last

few decades, it was inevitable that the technique initially established in knee

surgery would become more widely used in upper limb joints (shoulder, elbow,

wrist and hand). With improved techniques, camera systems and equipment,

previously difficult procedures are now possible. This is a brief overview

of the role of arthroscopy in some of the more common upper limb conditions.