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Arthroscopic Findings in Wrists with Severe Post-Traumatic Pain despite Normal Standard RadiographsFrom the Departments of Orthopaedic Surgery and Hand and Plastic Surgery, University Hospital, Linköping, Sweden and Department of Orthopaedic Surgery, Guy’s Hospital, London, UK Correspondence: Mr B. Povlsen, Consultant Orthopaedic Surgeon, Guy’s Hospital, St. Thomas Street, London SE1 9RT, UK. Tel.: +44-171-955-5000x5607; fax: +44-171-955-2759; E-mail: bo{at}povlsen.u-net.com This study assessed the role of diagnostic arthroscopy following a wrist injury in patients with normal standard radiographs, an unclear clinical diagnosis and persistent severe pain at 4 to 12 weeks. Forty-three patients were included after conservative management had failed to improve their wrist pain so that a stability test could be performed satisfactorily and underwent arthroscopy within 12 weeks. Arthroscopy revealed recent pathology in 41 wrists, of which 17 had significant ligament lesions that might have benefited from acute repair. We conclude that patients with marked persistent post-traumatic symptoms despite conservative management are likely to have sustained ligament injuries despite normal radiographs. We therefore recommend that under these circumstances an arthroscopy is carried out within 4 weeks if the patient and surgeon wish to acutely repair significant ligament injuries.
Key Words: acute wrist injury • normal radiographs • wrist pain • arthroscopy • ligament lesions
Journal of Hand Surgery (British and European Volume), Vol. 29, No. 3,
206-211 (2004) |
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