Is Wrist Arthroscopy Safer with the Nanoscope?

Abstract

Background Nanoscope, given its smaller size, may be safer when establishing dorsal wrist arthroscopy portals compared with the traditional 2.7 mm arthroscope.

Case Description Ten fresh frozen cadaver specimens were utilized. Dorsal radiocarpal portals were established with the Nanoscope and calipers were used to measure the distance between the portals and the surrounding anatomical structures. The only structure that was pierced during portal placement was the dorsal sensory branch of the ulnar nerve (DSUN) in one specimen when establishing the 6U portal. Our study did not note any tendon injuries.

Literature Review Traditional wrist arthroscopy may be performed with a 2.7 mm arthroscope. With its larger outer sheath cannula, this may place adjacent anatomical structures at risk of injury.

Clinical Relevance During wrist arthroscopy, the Nanoscope may be safer when creating portals to underlying structures.

Level of Evidence This is a Level IV study.

Keywords

wrist arthroscopy - arthroscope - surface anatomy - midcarpal radial - midcarpal ulnar

Ethical Approval

Cadaver study, there is no IRB but we have biospecimens approval.

Authors' Contribution

All the named authors were actively involved in the planning, enactment, and writing up of the study.

Publikationsverlauf

Eingereicht: 21. Dezember 2021

Angenommen: 28. April 2022

Artikel online veröffentlicht:
06. Juli 2022

• References

• 1 Ahsan ZS, Yao J. Complications of wrist and hand arthroscopy. Hand Clin 2017; 33 (04) 831-838
• 2 Gillis JA, Kakar S. Volar midcarpal portals in wrist arthroscopy. J Hand Surg Am 2019; 44 (12) 1094.e1-1094.e6
• 3 Hofmeister EP, Dao KD, Glowacki KA, Shin AY. The role of midcarpal arthroscopy in the diagnosis of disorders of the wrist. J Hand Surg Am 2001; 26 (03) 407-414
• 4 Slutsky DJ. Clinical applications of volar portals in wrist arthroscopy. Tech Hand Up Extrem Surg 2004; 8 (04) 229-238
• 5 Slutsky DJ, Nagle DJ. Wrist arthroscopy: current concepts. J Hand Surg Am 2008; 33 (07) 1228-1244
• 6 Abrams RA, Petersen M, Botte MJ. Arthroscopic portals of the wrist: an anatomic study. J Hand Surg Am 1994; 19 (06) 940-944
• 7 Corella F, Ocampos M, Cerro MD, Larrainzar-Garijo R, Vázquez T. Volar central portal in wrist arthroscopy. J Wrist Surg 2016; 5 (01) 80-90
• 8 Kiliç A, Kale A, Usta A, Bilgili F, Kabukçuoğlu Y, Sökücü S. Anatomic course of the superficial branch of the radial nerve in the wrist and its location in relation to wrist arthroscopy portals: a cadaveric study. Arthroscopy 2009; 25 (11) 1261-1264
• 9 Lourie GM, King J, Kleinman WB. The transverse radioulnar branch from the dorsal sensory ulnar nerve: its clinical and anatomical significance further defined. J Hand Surg Am 1994; 19 (02) 241-245
• 10 Naroura I, Zemirline A, Taleb C. et al. Inside-out method to develop volar arthroscopic portals of the wrist in cadaver specimens. Hand Surg Rehabil 2016; 35 (03) 210-214
• 11 Shyamalan G, Jordan RW, Kimani PK, Liverneaux PA, Mathoulin C. Assessment of the structures at risk during wrist arthroscopy: a cadaveric study and systematic review. J Hand Surg Eur Vol 2016; 41 (08) 852-858
• 12 Slutsky DJ. The use of a volar ulnar portal in wrist arthroscopy. Arthroscopy 2004; 20 (02) 158-163
• 13 Slutsky DJ. Distal radioulnar joint arthroscopy and the volar ulnar portal. Tech Hand Up Extrem Surg 2007; 11 (01) 38-44
• 14 Tryfonidis M, Charalambous CP, Jass GK, Jacob S, Hayton MJ, Stanley JK. Anatomic relation of dorsal wrist arthroscopy portals and superficial nerves: a cadaveric study. Arthroscopy 2009; 25 (12) 1387-1390
• 15 Cooney WP, Dobyns JH, Linscheid RL. Arthroscopy of the wrist: anatomy and classification of carpal instability. Arthroscopy 1990; 6 (02) 133-140