Skip to main content

Advertisement

SpringerLink
Log in

Arthroscopie du poignet: apport diagnostique et thérapeutique

Arthroscopy of the wrist following trauma

  • Published:
International Orthopaedics Aims and scope Submit manuscript

Summary

An arthroscopy was carried out on 23 wrist joints following trauma. There were 11 women and 12 men with a mean age of 36 years, and they were followed up for an average of 33 months. Statistically significant differences were observed in the radiolunate and scapho-lunate angles between the injured and normal sides. Arthroscopy detected 72 ligament tears, an average of 3 per wrist, compared with 1 per wrist demonstrated by arthrography. However the findings of the two investigations did not correlate, indicating that both are worth undertaking. Chrondromalacia was seen in 10 wrists, mostly in the radiocarpal and mid carpal joints. On the basis of the findings at arthroscopy, conservative treatment was followed in 60% of the patients and the investigation was of great help in planning operation in the remainder.

Résumé

Vingt-trois patients (11 femmes et 12 hommes) ont été revues dans le cadre d'une étude retrospective. L'âge moyen du collectif est de 36 ans. L'ensemble des patients souffrait de douleurs post-traumatiques du poignet. Une arthroscopie du carpe a été pratiquée après une analyse radiologique systématique (clichés standards et fonctionneles comparatifs et arthrographie). Le follow-up moyen est de 33 mois. Les radiographies standards permettent de déceller une différence significative des angles radiolunaire (p=0,01) et scapho-lunaire (p=0,029) par rapport au côté sain. L'arthroscopie met en évidence 72 foyers lésionnels, soit 3,1 déchirures ligamentaires par patients. L'arthrographie met en évidence 1,1 lésions par poignet. Elle reste néanmoins un complément utile à l'arthroscopie. Les lésions sont en général diffuses et localisées dans les articulations radio- et médiocarpienne ayant cependant une prédilection pour cette dernière. Une dégénérescence cartilagineuse a été observée chez 10 patients, essentiellement dans la radiocarpienne. Sur la base de l'arthroscopie, il a été possible de renoncer chez 60% des patients à pratiquer une intervention. Pour le 40% restant, l'arthroscopie a permis de préciser la tactique opératoire. L'arthroscopie du poignet est devenu un examen de référence incontournable du poignet traumatique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Bibliographie

  1. Berger RA, Blair WF, Crowninshield RD, Flatt AE (1982) The scapholunate ligament. J Hand Surg 7: 87–91

    Google Scholar 

  2. Berger RA, Linscheid RL, Berquist TH (1994) Magnetic resonance imaging of the anterior radiocarpal ligaments. J Hand Surg 19A: 295–303

    Google Scholar 

  3. Blatt G (1987) Capsulodesis in reconstructive hand surgery. Dorsal capsulodesis for the unstable scaphoïd and volar capsulodesis following excision of the distal ulna. Hand Clinic 3: 81–102

    Google Scholar 

  4. Botte MJ, Cooney WP, Linscheid RL (1989) Arthroscopy of the wrist: Anatomy and technique. J Hand Surg 14A: 313–316

    Google Scholar 

  5. Burman MS (1931) Arthroscopy or the direct visualization of joints. J Bone Joint Surg 4: 669–695

    Google Scholar 

  6. Chamay A, Della Santa D, Vilaseca A (1983) L'arthrodèse radio-lunaire, facteur de stabilité du poignet rhumatoïde. Ann Chir Main 2: 5–17

    Google Scholar 

  7. Kuhlman JN, Luboinski J, Laudet C, Boabighi A, Landjerit B, Guerin-Surville H, Baux S (1990) Properties of the fibrous structure of the wrist. J Hand Surg 15B: 335–341

    Google Scholar 

  8. Lichtmann DM, Scheider JR, Swafford AR, Mack GR (1981) Ulnar midcarpal instability: clinical and laboratory analysis. J Hand Surg 6: 515–523

    Google Scholar 

  9. McAliffe JA, Dell PC, Jaffe R (1993) Complications of intercarpal arthrodesis. J Hand Surg 18A: 1121–1128

    Google Scholar 

  10. McMurtry RY, Youm Y, Flatt AE, Gillespie TE (1978) Kinematics of the wrist 2: clinical applications. J Bone Joint Surg [Am] 60: 955–961

    Google Scholar 

  11. Nattrass GR, King GY, McMurtry R, Brant RF (1994) An alternative method for determination of the carpal height ratio. J Bone Joint Surg [Am] 76: 88–92

    Google Scholar 

  12. North ER, Meyer S (1990) Wrist injuries: correlation of clinical and arthroscopic findings. J Hand Surg 15A: 915–920

    Google Scholar 

  13. Palmer AK (1990) Triangular fibrocartilage disorders: Injury patterns and treatment. Arthroscopy 6: 125–132

    Google Scholar 

  14. Roth JH, Haddad RG (1986) Radiocarpal arthroscopy and arthrography in the diagnosis of ulnar wrist pain. Arthroscopy 2: 234–243

    Google Scholar 

  15. Sennwald GR, Segmüller G (1986) Base anatomique d'un nouveau concept de stabilité du carpe. Int Orthop 10: 25–30

    Google Scholar 

  16. Sennwald GR, Zdravkovic V, Jacob HAC, Kern HP (1993) Kinematic analysis of relative motion within the proximal carpal row. J Hand Surg [Br] 18: 609–612

    Google Scholar 

  17. Sennwald GR, Zdravkovic V, Oberlin C (1994) The anatomy of the palmar scaphotriquetral ligament. J Bone J Surg [Br] 76: 147–149

    Google Scholar 

  18. Wachtl SW, Sennwald GR, Rodriguez M (1994) Evolution à long terme des prothèses en silastic du semi-lunaire. Ann Chir Main. 13: 36–41

    Google Scholar 

  19. Whipple TL, Marotta JJ, Powell JH (1986) Techniques of wrist arthroscopy. Arthroscopy 2: 244–252

    Google Scholar 

  20. Youm Y, McMurtry RY, Flatt AE, Gillespie TE (1978) Kinematics of the wrist 1: experimental study. J Bone J Surg [Am] 60: 423–431

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopädische Universitätsklinik Balgrist, Forchstrasse 340, CH-8008, Zürich, Suisse

    S. W. Wachtl

  2. Chirurgie St-Leonhard, Pestalozzistrasse 2, CH-9000, St Gallen, Suisse

    G. R. Sennwald

Authors
  1. S. W. Wachtl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. R. Sennwald
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wachtl, S.W., Sennwald, G.R. Arthroscopie du poignet: apport diagnostique et thérapeutique. International Orthopaedics 19, 339–345 (1995). https://doi.org/10.1007/BF00178345

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00178345

Search

Navigation