Publication: Nuevo portal volar en artroscopia de muñeca
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2016-07-08
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Universidad Complutense de Madrid
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Abstract
Los portales utilizados en la artroscopia de muñeca inicialmente son portales dorsales. Con el desarrollo de los portales volares, ha sido posible el abordaje artroscópico de la muñeca desde cualquier ángulo. PORTALES DORSALES. Los portales dorsales de la articulación radiocarpiana se nombran según su relación con los tendones de los compartimentos extensores del dorso del radio 1-/2, 3-/4, 4-/5, 6R y 6U. Los portales dorsales mediocarpianos radial y ulnar se encuentran 1 cm distal a los portales 3-/4 y 4-/5 respectivamente. Son los portales más utilizados y obtienen una adecuada visión de la articulación radiocarpiana y de la cápsula volar, pero no permiten una adecuada visión del ligamento radiopiramidal dorsal ni de la región palmar de los ligamentos lunopiramidal y escafolunar. PORTALES VOLARES. Aunque algunos autores han descrito portales volares para la articulación radiocarpiana, los más utilizados en la actualidad son los propuestos por Slutsky: portal volar radial y portal volar ulnar. También describe un portal volar para la articulación mediocarpiana a través de la misma incisión que para el portal volar radial y a 11cm distal a la misma. Los portales volares obtienen una adecuada visión de la región dorsal de la muñeca, y de la porción palmar de los ligamentos lunopiramidal y escafolunar…
The standard portals for wrist arthroscopy are mostly dorsal. With the advent of volar portals, it is now posible to have viewing and working portals thart encircle the wrist . DORSAL PORTALS. The dorsal portals which allow access to the radiocartpal joint are so named in relation to the tendons of the dorsal extensor compartments: 1-/2, 3-/4, 4-/5, 6R and 6U. The midcarpal joint is assessed through two portals. The radial midcarpal portal is located 1cm distal to the 3-/4 portal, and the ulnar midcarpal ulnar portal 1 to 1.5 cm distal to the 4-/5 portal. The dorsal portals are most commonly used and obtain an adequate view of the radiocarpal joint and the dorsal capsule but don´t allow an adequate view of the dorsal radiocarpal ligament nor the palmar subregion of the scapholunate interosseous ligament and lunotriquetral interosseous ligament. VOLAR PORTALS. Although several volar radiocarpal portals have been described, the most used today are those proposed by Slutsky: the volar radial portal and the volar ulnar portal. Slutsky also describes a volar radial midcarpal through the same skin incision tham the volar radial portal; the distance between the radiocarpal and midcarpal entry sites averages 11cm. The volar portals obtain an adequate view of the dorsal capsular structures and the palmar subregions of the interosseous ligaments, but the realization of two volar portals to get this complete view is necessary…
The standard portals for wrist arthroscopy are mostly dorsal. With the advent of volar portals, it is now posible to have viewing and working portals thart encircle the wrist . DORSAL PORTALS. The dorsal portals which allow access to the radiocartpal joint are so named in relation to the tendons of the dorsal extensor compartments: 1-/2, 3-/4, 4-/5, 6R and 6U. The midcarpal joint is assessed through two portals. The radial midcarpal portal is located 1cm distal to the 3-/4 portal, and the ulnar midcarpal ulnar portal 1 to 1.5 cm distal to the 4-/5 portal. The dorsal portals are most commonly used and obtain an adequate view of the radiocarpal joint and the dorsal capsule but don´t allow an adequate view of the dorsal radiocarpal ligament nor the palmar subregion of the scapholunate interosseous ligament and lunotriquetral interosseous ligament. VOLAR PORTALS. Although several volar radiocarpal portals have been described, the most used today are those proposed by Slutsky: the volar radial portal and the volar ulnar portal. Slutsky also describes a volar radial midcarpal through the same skin incision tham the volar radial portal; the distance between the radiocarpal and midcarpal entry sites averages 11cm. The volar portals obtain an adequate view of the dorsal capsular structures and the palmar subregions of the interosseous ligaments, but the realization of two volar portals to get this complete view is necessary…
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 30/09/2015