Arthroscopic Arthrolysis of the Wrist

Secondary wrist stiffness usually occurs following trauma or surgery and is classified as intra-articular, capsular, or extra-articular. Arthrofibrosis affects the radiocarpal, midcarpal, ulnocarpal, and/or distal radioulnar joints. Conservative treatment is the mainstay of management. Once conservative modalities fail, surgical arthrolysis, either open or arthroscopic, helps to relieve pain and restore motion. Arthroscopic arthrolysis involves resection of intra-articular adhesions, chondral debridement, capsulotomy, and release of radiocarpal ligaments. Arthroscopy will often reveal other occult pathologies which can be treated during the same procedure if appropriate. Rehabilitation should be started immediately after surgery and individualized to the pathologies and requirements of the patient. Arthroscopic arthrolysis is the surgical treatment of choice as it is less invasive, allows immediate postoperative mobilization with minimal scarring.