Arthroscopic arthrolysis

Wrist stiffness is a debilitating condition that may complicate a traumatic injury to the wrist or follow immobilization of the wrist in a brace or plaster cast. We classify joint contracture (stiffness) as either intra-articular, capsular, or extra-articular. Arthrofibrosis is the predominant intra-articular pathology encountered and may involve the radiocarpal, radioulnar, and/or ulnocarpal joints. Treatment initially consists of a prolonged course of conservative treatment involving therapists. Following failure of conservative treatment, arthroscopic arthrolysis is an effective treatment for reestablishing range of motion and improving patient’s pain. At the same time other intra-articular pathologies may be identified and treated. The postoperative rehabilitation protocol needs to be considered when treating other coexistent pathologies, as early postoperative mobilization is mandatory following arthrolysis. The surgical procedure involves resection of intra-articular adhesions, capsulotomy, and possible release of the radiocarpal ligaments. Due to the complex nature of this condition, certain parts of the procedure may need to be performed as an open procedure. Satisfactory results may be obtained following surgery with improvement in range of motion.