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Published in: International Orthopaedics 6/2012

01-06-2012 | Original Paper

Wrist arthroscopy in children and adolescents: a single surgeon experience of thirty-four cases

Authors: Sebastian Farr, Franz Grill, Werner Girsch

Published in: International Orthopaedics | Issue 6/2012

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Abstract

Purpose

The purpose of this study was to report our experience of wrist arthroscopy in children and adolescents with chronic wrist pain in a retrospective single surgeon series. Therefore, technical differences or obstacles compared to standard wrist arthroscopy in adults, and complications were highlighted.

Methods

A retrospective data review of all patients undergoing wrist arthroscopy between 2002 and 2011 was performed. The basic inclusion criteria was chronic, therapy refractory wrist pain for more than three months in children and adolescents aged 18 years and younger. In total, 34 arthroscopies in 27 girls and six boys were reviewed. The mean age at time of arthroscopic exploration was 14.6 years (range, 9.8–17.9 years).

Results

A total of 28 wrists showed a triangular fibrocartilage complex (TFCC) tear (82.4%). In 26 of 34 (76.5%) inspected wrist joints additional pathologies besides TFCC tears were documented. As a consequence, 14 arthroscopic TFCC resections, two arthroscopic TFCC repairs and seven open resection arthroplasties were performed. Other concomitant procedures (e.g. ulna shortening) were performed in 25 patients (26 wrists) because of predisposing malformations. No intraoperative or postoperative complications related to the arthroscopies were observed. No relevant technical differences to wrist arthroscopy in adults were experienced apart from cases of major anatomical malformations.

Conclusions

Wrist arthroscopy has been shown to be a safe procedure to detect and treat paediatric wrist disorders. Nevertheless, we believe that this procedure should only be carried out by well-trained, experienced hand surgeons.
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Literature
1.
2.
go back to reference Schers TJ, van Heusden HA (1995) Evaluation of chronic wrist pain. Arthroscopy superior to arthrography: comparison in 39 patients. Acta Orthop Scand 66(6):540–542PubMedCrossRef Schers TJ, van Heusden HA (1995) Evaluation of chronic wrist pain. Arthroscopy superior to arthrography: comparison in 39 patients. Acta Orthop Scand 66(6):540–542PubMedCrossRef
3.
4.
go back to reference Huracek J, Chomiak J (2002) Diagnostic arthroscopy of the wrist in adults and children with subsequent single-stage surgical procedures. Acta Chir Orthop Traumatol Cech 69(2):99–102PubMed Huracek J, Chomiak J (2002) Diagnostic arthroscopy of the wrist in adults and children with subsequent single-stage surgical procedures. Acta Chir Orthop Traumatol Cech 69(2):99–102PubMed
5.
go back to reference Knopp W, Neumann K, Muhr G, Hinrichsen K (1988) Arthroscopy of the proximal wrist joint. Indications, technic and clinical results. Unfallchirurg 91(1):22–28PubMed Knopp W, Neumann K, Muhr G, Hinrichsen K (1988) Arthroscopy of the proximal wrist joint. Indications, technic and clinical results. Unfallchirurg 91(1):22–28PubMed
6.
go back to reference Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34(5):582–591CrossRef Atzei A (2009) New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability. J Hand Surg Eur 34(5):582–591CrossRef
7.
go back to reference Westkaemper JG, Mitsionis G, Giannakopoulos PN, Sotereanos DG (1998) Wrist arthroscopy for the treatment of ligament and triangular fibrocartilage complex injuries. Arthroscopy 14(5):479–483PubMedCrossRef Westkaemper JG, Mitsionis G, Giannakopoulos PN, Sotereanos DG (1998) Wrist arthroscopy for the treatment of ligament and triangular fibrocartilage complex injuries. Arthroscopy 14(5):479–483PubMedCrossRef
8.
go back to reference Wachtl SW, Sennwald GR (1995) Arthroscopy of the wrist: diagnostic and therapeutic contribution. Int Orthop 19(6):339–345PubMedCrossRef Wachtl SW, Sennwald GR (1995) Arthroscopy of the wrist: diagnostic and therapeutic contribution. Int Orthop 19(6):339–345PubMedCrossRef
9.
go back to reference De Smet L, Dauwe D, Fortems Y, Zachee B, Fabry G (1996) The value of wrist arthroscopy. An evaluation of 129 cases. J Hand Surg Br 21(2):210–212PubMedCrossRef De Smet L, Dauwe D, Fortems Y, Zachee B, Fabry G (1996) The value of wrist arthroscopy. An evaluation of 129 cases. J Hand Surg Br 21(2):210–212PubMedCrossRef
10.
go back to reference Siparsky PN, Kocher MS (2009) Current concepts in pediatric and adolescent arthroscopy. Arthroscopy 25(12):1453–1469PubMedCrossRef Siparsky PN, Kocher MS (2009) Current concepts in pediatric and adolescent arthroscopy. Arthroscopy 25(12):1453–1469PubMedCrossRef
11.
go back to reference Alt V, Gasnier J, Sicre G (2004) Injuries of the scapholunate ligament in children. J Pediatr Orthop B 13(5):326–329PubMedCrossRef Alt V, Gasnier J, Sicre G (2004) Injuries of the scapholunate ligament in children. J Pediatr Orthop B 13(5):326–329PubMedCrossRef
12.
go back to reference Earp BE, Waters PM, Wyzykowski RJ (2006) Arthroscopic treatment of partial scapholunate ligament tears in children with chronic wrist pain. J Bone Joint Surg Am 88(11):2448–2455PubMedCrossRef Earp BE, Waters PM, Wyzykowski RJ (2006) Arthroscopic treatment of partial scapholunate ligament tears in children with chronic wrist pain. J Bone Joint Surg Am 88(11):2448–2455PubMedCrossRef
14.
go back to reference Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14(4):594–606PubMedCrossRef Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14(4):594–606PubMedCrossRef
15.
go back to reference Terry CL, Waters PM (1998) Triangular fibrocartilage injuries in pediatric and adolescent patients. J Hand Surg Am 23(4):626–634PubMedCrossRef Terry CL, Waters PM (1998) Triangular fibrocartilage injuries in pediatric and adolescent patients. J Hand Surg Am 23(4):626–634PubMedCrossRef
16.
go back to reference Chou CH, Lee TS (2001) Peripheral tears of triangular fibrocartilage complex: results of primary repair. Int Orthop 25(6):392–395PubMedCrossRef Chou CH, Lee TS (2001) Peripheral tears of triangular fibrocartilage complex: results of primary repair. Int Orthop 25(6):392–395PubMedCrossRef
17.
go back to reference Puhaindran ME, Yam AK, Chin AY, Lluch A, Garcia-Elias M (2009) Wrist arthroscopy: beware the novice. J Hand Surg Eur 34(4):540–542 Puhaindran ME, Yam AK, Chin AY, Lluch A, Garcia-Elias M (2009) Wrist arthroscopy: beware the novice. J Hand Surg Eur 34(4):540–542
18.
go back to reference De Smet L (2002) Pitfalls in wrist arthroscopy. Acta Orthop Belg 68(4):325–329PubMed De Smet L (2002) Pitfalls in wrist arthroscopy. Acta Orthop Belg 68(4):325–329PubMed
19.
go back to reference Warhold LG, Ruth RM (1995) Complications of wrist arthroscopy and how to prevent them. Hand Clin 11(1):81–89PubMed Warhold LG, Ruth RM (1995) Complications of wrist arthroscopy and how to prevent them. Hand Clin 11(1):81–89PubMed
20.
go back to reference Beredjiklian PK, Bozentka DJ, Leung YL, Monaghan BA (2004) Complications of wrist arthroscopy. J Hand Surg Am 29(3):406–411PubMedCrossRef Beredjiklian PK, Bozentka DJ, Leung YL, Monaghan BA (2004) Complications of wrist arthroscopy. J Hand Surg Am 29(3):406–411PubMedCrossRef
21.
go back to reference Gallego S, Mathoulin C (2010) Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy 26(12):1675–1682PubMedCrossRef Gallego S, Mathoulin C (2010) Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy 26(12):1675–1682PubMedCrossRef
22.
go back to reference Van Meir N, Degreef I, De Smet L (2011) The volar portal in wrist arthroscopy. Acta Orthop Belg 77(3):290–293PubMed Van Meir N, Degreef I, De Smet L (2011) The volar portal in wrist arthroscopy. Acta Orthop Belg 77(3):290–293PubMed
23.
go back to reference Rocchi L, Canal A, Pelaez J, Fanfani F, Catalano F (2006) Results and complications in dorsal and volar wrist Ganglia arthroscopic resection. Hand Surg 11(1–2):21–26PubMedCrossRef Rocchi L, Canal A, Pelaez J, Fanfani F, Catalano F (2006) Results and complications in dorsal and volar wrist Ganglia arthroscopic resection. Hand Surg 11(1–2):21–26PubMedCrossRef
24.
go back to reference Pell RF 4th, Uhl RL (2004) Complications of thermal ablation in wrist arthroscopy. Arthroscopy 20(Suppl 2):84–86PubMed Pell RF 4th, Uhl RL (2004) Complications of thermal ablation in wrist arthroscopy. Arthroscopy 20(Suppl 2):84–86PubMed
25.
go back to reference Nguyen MK, Bourgouin S, Gaillard C, Butin C, Guilhem K, Levadoux M, Legre R (2011) Accidental section of the ulnar nerve in the wrist during arthroscopy. Arthroscopy 27(9):1308–1311PubMedCrossRef Nguyen MK, Bourgouin S, Gaillard C, Butin C, Guilhem K, Levadoux M, Legre R (2011) Accidental section of the ulnar nerve in the wrist during arthroscopy. Arthroscopy 27(9):1308–1311PubMedCrossRef
Metadata
Title
Wrist arthroscopy in children and adolescents: a single surgeon experience of thirty-four cases
Authors
Sebastian Farr
Franz Grill
Werner Girsch
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1428-y

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