Arthroscopic wrist arthrolysis after wrist fracture.
OBJECTIVE
To evaluate the results of this surgical procedure in patients affected by wrist stiffness after wrist fracture. Criteria for patient inclusion in our preoperative and postoperative study were wrist stiffness with or without pain, decreased grip strength, and unsuccessful results 3 to 6 months after following a rehabilitation program.


METHODS
From 1988 to 2003, surgery was performed in 22 patients (16 men and 6 women) with a mean age of 37 years. Radiocarpal, midcarpal, and distal radioulnar joint portals were used in relation to the site of rigidity. Statistical evaluation was performed in all cases.


RESULTS
At a mean follow-up of 28 months (range, 9 to 144 months), no complications were documented. One case that was operated on bilaterally successively required an additional right wrist arthroscopic arthrolysis to reach the same level of improvement as that of the contralateral side. Pain was almost absent in all cases (P < .0001), and mean flexion/extension range of motion increased from 84 degrees preoperatively to 99 degrees postoperatively, mean pronation/supination increased from 144 degrees to 159 degrees, and mean grip strength increased from 22 to 28 kg (P < .0001). The mean modified Mayo wrist score improved from 28 to 79 postoperatively (P < .0001), and the mean postoperative score on the Disabilities of the Arm, Shoulder and Hand questionnaire was 21 points.


CONCLUSIONS
Arthroscopic wrist arthrolysis is a suitable and promising surgical option for the treatment of wrist rigidity after trauma or surgery. In our series pain and wrist flexion-extension and grip strength significantly improved. The procedure is safe and required a minimal amount of invasive surgery while also permitting the surgeon to identify the precise cause of the intra-articular rigidity and pain.


METHODS
Level IV, therapeutic case series.
Luchetti
Riccardo
R
Rimini Hand Center, Rimini, Italy. rluc@adhoc.net
Atzei
Andrea
A
Fairplay
Tracy
T
D000328:Adult; D001182:Arthroscopy; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology* / Q000601:surgery*; D008297:Male; D014954:Wrist Injuries / Q000150:complications*; D014955:Wrist Joint