Arthroscopy has been widely used in the knee and shoulder joints, and with the continuous improvement and refinement of cameras and various arthroscopic instruments, arthroscopy is gradually being applied to other joints, including the wrist joint. The wrist joint is a complex joint consisting of eight small carpal bones and many ligaments attached to the carpal bones. Arthroscopy allows the surgeon to look at the internal structures of the joint and its movements to make accurate judgments. Diagnostic Arthroscopy If the cause of your wrist pain is unknown or if the pain persists after months of conservative treatment, then a diagnostic wrist arthroscopy may be an option. Before the procedure the doctor will need to perform: Physical examination: Focus on the hand and wrist. The doctor will also need to ask about your medical history. Stimulation test: Move the wrist joint to trigger the pain. Imaging tests: such as x-rays of the hand and wrist, and in some cases CT and MRI. Wrist arthroscopy can usually be performed under brachial plexus anesthesia, with 2-3 entries on the dorsal side of the wrist, and insertion of the arthroscope and various instruments for the procedure. Wrist arthroscopy Many conditions can be treated with wrist arthroscopy, including chronic wrist pain, intra-articular fractures, tendon sheath cysts, ligament tears, and injuries to the triangular fibrocartilage complex. Carpal arthroscopy can also be used to smooth the surface of the bone to remove inflammatory tissue. Carpal arthroscopy can also be used to treat carpal tunnel syndrome, in which the arthroscope does not enter the carpal joint. Chronic wrist pain: Wrist arthroscopy can be performed when other tests are unable to determine the cause of chronic wrist pain. It is usually possible to find regional inflammation, damage to cartilage, or other post-traumatic changes. These conditions can usually be treated arthroscopically after a clear diagnosis is made. Wrist fractures: The surgeon can use arthroscopy to remove small fracture fragments, reposition the fracture, and fix it with kerf pins, sutures, or screws. Tenosynovial cysts: These cysts often communicate with the articular cavity between the carpal bones through the tip, which can be removed arthroscopically to reduce recurrence of the cyst. Tears of the ligament and triangular fibrocartilage complex: The ligament connects the carpal bones and provides stability and support to the wrist joint, and the triangular fibrocartilage complex is a cushioning structure in the wrist joint. A fall with the wrist in dorsiflexion can damage the ligament and triangular fibrocartilage complex, causing pain and popping during movement. These injuries can be repaired or smoothed by an arthroscopic surgeon. Carpal tunnel release: Carpal tunnel syndrome, which manifests as numbness and tingling in the hand, is caused by excessive pressure on the nerve in the carpal tunnel. The factors that cause increased pressure in the carpal tunnel are inflammation and swelling of the synovial tissue of the tendon sheath. When conservative treatment does not work, the surgeon may recommend removing the ligament to widen the carpal tunnel and relieve the pressure on the median nerve to relieve symptoms. This procedure can be performed arthroscopically with a wrist arthroscope. After arthroscopic wrist surgery, the affected limb is usually elevated for 2-3 days and ice is applied to reduce swelling. The surgeon will teach you some exercises to restore range of motion and strength. Pain after surgery is usually mild, but pain medication may be used if the pain is severe. Complications Intraoperative and postoperative complications of wrist arthroscopy are rare, but sometimes infection, nerve damage, excessive swelling and bleeding, scar adhesions or tendon tears can occur. An experienced arthroscopist can minimize these complications. Summary Wrist arthroscopy is an effective means of diagnosing and treating wrist disorders, with the advantages of less trauma, faster recovery, and fewer complications than incisional surgery.