Wrist arthroscopy

Artroskopija ručnog zgloba je minimalno invazivna endoskopska metoda koja omogućuje dijagnosticiranje i liječenje pojedinih bolesti i ozljeda ručnog zgloba (RZ), mediokarpalnog zgloba (MKZ) i distalnog radioulnarnog zgloba (DRUZ). Ovu minimalno invazivnu kiruršku metodu prvi je opisao Yung-Cheng Chen 1979., no njezina šira primjena u kliničkoj praksi počinje tek nakon 1986., kada je Terry Lane Whipple preporučio distrakciju RZ-a i precizne lokalizacije ulaznih mjesta (portala), kako bi se učinila pravilna i potpuna evaluacija RZ-a prilikom izvođenja artroskopije. Iako je prvotno artroskopija RZ-a bila samo dijagnostička metoda, tijekom vremena, zahvaljujući kontinuiranom napretku tehnologije i uvođenju inovacija u instrumentaciji i operativnoj tehnici, artroskopija RZ-a postaje i terapeutska metoda. Cilj ovog rada prikazati je osnove o artroskopiji RZ-a, a one uključuju: povijesni razvoj, indikacije i kontraindikacije, evaluaciju i probir bolesnika za artroskopiju RZ-a na temelju anamneze, fizikalnog pregleda i slikovne obrade, pripremu za artroskopiju RZ-a, potrebnu opremu, poznavanje izvanzglobne anatomije, portale (ulazna mjesta), poznavanje unutarzglobne anatomije, preduvjete, tehniku artroskopije RZ-a, prednosti i nedostatke ove operativne metode, komplikacije i zaključak.
Wrist arthroscopy is minimally invasive endoscopic procedure which enables the diagnosis and treatment of certain diseases and injuries of the wrist joint (WJ), midcarpal joints (MCJs) and distal radioulnar joint (DRUJ). This minimally invasive surgical procedure was first described by Yung-Cheng Chen in 1979. However, its widespread application in clinical practice began after 1986, when Terry Lane Whipple recommended wrist distraction and precise localization of portals to do proper and complete evaluation of the wrist when performing arthroscopy. Although initially wrist arthroscopy was only a diagnostic tool, during time due to the continuous advancement of technology and the introduction of innovations in instrumentation and surgical technique, wrist arthroscopy became a therapeutic method. The aim of this professional paper is to present the basics of wrist arthroscopy, which include: historical development, indications and contraindications, evaluation and selection of patients for wrist arthroscopy on the basis of history, physical examination and diagnostic imaging procedures, wrist arthroscopy setup, the necessary equipment, superficial anatomy, portals, intraarticular anatomy, preconditions, technique of wrist arthroscopy, the advantages and disadvantages of this surgical procedure, complications, and conclusion.