Wrist Arthroscopy

When a hand surgeon performs a wrist arthroscopy, a series of very small incisions or portals are made that are used to examine the wrist. Arthroscopy, itself, comes from the Greek words arthro which means joint, and skopein, to look, and the wrist undergoes arthroscopy nearly as often as the shoulder and knee.

The incisions permit your hand surgeon to examine the many bones and ligaments that make up the wrist joint with minimal pain and stiffness for the patient.

Wrist arthroscopy is a relatively painless way for the hand surgeon to visually examine the ligaments that connect the bones in the wrist and the cartilage in the joints that make up the wrist. It is used to determine the cause of clicks, pain, and swelling, and is a better tool than x-rays or scans for determining the health of bones, cartilage, and ligaments.

If there are problems with the wrist, they can often be treated by the small incisions and special tools utilized by arthroscopy. It can treat some fractures in the wrist, or determine the health of the TFCC, or triangular fibrocartilage, the wrist's meniscus. Certain types of arthritis can be evaluated and treated through wrist arthroscopy, and it can even be used to remove ganglion cysts.

When wrist arthroscopy is performed, a tiny camera is placed on the end of a fiber-optic tube no thicker than a knitting needle that is inserted through an incision the length of a grain of rice and directly into the back of the wrist (figure 2). The tiny camera is directed to look at the bones and tissues that make up the wrist. Its lens magnifies the structures and projects them onto a TV screen the hand doctor can study to more easily diagnose any condition or disease.

There are usually several small incisions made in the wrist, and the camera is moved between them to give a more complete picture of the joint. The wrist is often bent and filled with a fluid that expands the joints and makes its structures easier to see.

In addition to the camera, other small instruments can be attached to the tube to further the diagnosis and treat conditions that are found. Wrist arthroscopy is often done with more traditional, open surgery.

A splint to protect the wrist will usually be placed around it after the arthroscopy, but your fingers will be able to move freely. How long the splint needs to stay on will depend on what treatments were performed during the surgery, but is typically a matter of weeks. It is important that the wrist is kept elevated after the arthroscopy to keep the swelling and pain at a minimum. 

There are some risks following wrist arthroscopy, just as there are after any surgery. In less than 1% of the cases, for example, there can be injury to nerves or tendons in the wrist. There may be stiffness afterwards, which can be treated with rehabilitation and therapy.

While arthroscopy is frequently the preferred way to treat a wrist condition, it isn't the best way to treat all the conditions the wrist is subject to. It's success depends, in part, on the training, experience, and expertise of the surgeon who performs it.