Removal of dorsal ganglion cyst

Post-traumatic osteoarthritis of the wrist often requires the use of palliative surgeries. Partial arthrodesis is one of the proposed techniques. They are numerous, and in this video, we report an original arthroscopic arthrodesis between scaphoid and capitate for localized osteoarthritis on the lateral side of the midcarpal joint, after an old chronic scapholunate ligament tear.

The origin and the physiopathology of wrist ganglia are still debated. We know for sure that most of them have a common origin on the dorsal aspect of the wrist capsule in correspondence to the scapholunate ligament. The most common explanation is that there is a valve mechanism at the base of the ganglion, which controls the variable volume of these ganglions.
Therefore, the ganglion can be healed by resecting this valve mechanism at the capsular level. Resecting greater parts of the dorsal wrist capsule can often lead to joint stiffness and secondary weakness of the dorsal capsule.
Therefore, the arthroscopic resection of the ganglion stalk will heal the ganglion using a minimally invasive technique and hence avoiding the disadvantages of open surgery.
Technically speaking, a diagnostic wrist arthroscopy is performed through the ulnocarpal portals. This allows to eliminate any co-existing pathology. It also allows to see whether the stalk of the ganglion is in an ulnocarpal or a radiocarpal position.
A shaver is then introduced through the ganglion itself into the stalk, and intensive shaving is performed at the dorsal capsule in correspondence to the origin of the ganglion. Complete resection can thereby be achieved. Special postoperative care or splinting is not necessary. Mobilization can be started immediately.

In this key lecture, Dr. Haerle outlines DRUJ instability due to irreparable TFCC tear.

In this key lecture, Dr. Camus outlines the wrist arthroscopic dorsal capsuloligamentous repair.

The triangular fibrocartilage complex (TFCC) plays an essential role in the stability of the distal radioulnar joint (DRUJ) stability. In this lecture, Dr. Nakamura presents the surgical approach to the TFCC.

In this key lecture, Dr. Muratore outlines wrist arthroscopic anatomy.

Fractures of the distal radius can cause major functional disorders when the reduction was not perfect, especially articular fractures. Treatment of malunion is difficult. It requires a deep understanding of the particular anatomy of the distal articular surface in direct contact with the wrist. A precise preoperative planning will reduce and fix the different fragments in good position.

In this key lecture, Dr. Levadoux focuses on the arthroscopic treatment of SLAC wrist I and II by large styloidectomy associated with a tendon autograft interposition arthroplasty tightened as a hammock. The technique and preliminary results are presented.

The triangular fibrocartilage complex (TFCC) is often torn during sport injury in torsion.
Sometimes, the foveal attachment of the TFCC is detached. This video shows one of the technique available. The objective is to re-attach the TFCC into the foveal area of the ulna, with the help of an absorbable micro-anchor, using a trick in order to achieve two fixations with only one suture.