Arthroscopy and Endoscopy of the Elbow, Wrist and Hand: Surgical Anatomy and Techniques

Foreword
Preface
	ISAKOS Elbow Wrist and Hand Committee
	Aim of the Book
	Organization and Content
	Acknowledgments
Contents
Part I: History
	1: The Early Development of Arthroscopy
		1.1	 Introduction
		1.2	 The Primitive Phase
		1.3	 Early Development
		1.4	 The Beginnings of Therapeutic Arthroscopy
		1.5	 A Period of Refinement
		1.6	 Timeline
		References
	2: History of Wrist Arthroscopy
		2.1	 Introduction
		2.2	 Early Wrist Arthroscopy
		2.3	 A Match Was Struck
		2.4	 Broadening the Possibilities
		2.5	 Organizations
		2.6	 Journals and Books
		2.7	 Timeline
		References
Part II: Elbow: Basic Science
	3: Clinical Anatomy of the Elbow
		3.1	 Clinical Anatomy of the Elbow
			3.1.1	 Osseous Anatomy
			3.1.2	 Subcutaneous Plane
			3.1.3	 Deep Investing Fascia of the Upper Limb
		3.2	 Muscular Layer
			3.2.1	 Biceps Brachii Muscle
			3.2.2	 Triceps Brachii Muscle
			3.2.3	 Anconeus Muscle
			3.2.4	 Supinator Muscle
			3.2.5	 Cubital Fossa
			3.2.6	 Pronator Teres Muscle
			3.2.7	 Brachialis Muscle
			3.2.8	 Brachioradialis Muscle
			3.2.9	 Extensor Muscles
			3.2.10	 Neural Tubes About the Elbow
			3.2.11	 Ulnar Nerve
			3.2.12	 Radial Nerve
			3.2.13	 Median Nerve
			3.2.14	 Capsular Anatomy
			3.2.15	 Ulnar Collateral Ligament
			3.2.16	 Lateral Ligament Complex
		References
	4: Elbow Anatomy: A Layered Approach
		4.1	 Background
		4.2	 Anatomical Layers of the Elbow
		References
	5: Surgical Anatomy of the Nerves Around the Elbow
		5.1	 Background
		5.2	 Cutaneous Nerves of the Upper Limb
		5.3	 Radial Nerve
			5.3.1	 Radial Tunnel and Posterior Interosseous Nerve
		5.4	 Median Nerve
			5.4.1	 The Supracondylar Process and Ligament of Struthers
			5.4.2	 Lacertus Fibrosus and the Pronator Teres
		5.5	 Ulnar Nerve
			5.5.1	 Arcade of Struthers
			5.5.2	 Medial Intermuscular Septum
			5.5.3	 Anconeus Epitrochlearis Muscle
			5.5.4	 Cubital Tunnel
			5.5.5	 Deep Flexor-Pronator Aponeurosis
		5.6	 Lateral Cutaneous Nerve of the Forearm
			5.6.1	 Lateral Free Edge of the Biceps Tendon
		5.7	 Arthroscopic Portals and Neurovascular Structures
		References
	6: Arthroscopic Equipment and Set-Up for Elbow Arthroscopy
		6.1	 Background
		6.2	 Planning and Layout
		6.3	 Anaesthesia
		6.4	 Positioning
		6.5	 Equipment
		6.6	 Getting Started
		6.7	 Tips and Tricks
		References
	7: Portals and Technique for Diagnostic Elbow Arthroscopy
		7.1	 Introduction
		7.2	 Indications
		7.3	 Contraindications
		7.4	 Equipment
		7.5	 Position
		7.6	 The Elbow “Joint Box” Concept
		7.7	 Surface Anatomy
		7.8	 Joint Distension
		7.9	 Portals
		7.10	 The “2 cm Rule”
			7.10.1	 Anterior Compartment
			7.10.2	 Posterior Compartment
		7.11	 Tips and Tricks
		7.12	 Pitfalls
		7.13	 Postoperative Management and Rehabilitation
		7.14	 Complications
		7.15	 Results
		References
	8: Transarticular Posterolateral Portal for Elbow Arthroscopy
		8.1	 Background
		8.2	 Indications and Contraindications
		8.3	 Surgical Technique
		8.4	 Tips and Tricks
		8.5	 Pitfalls
		8.6	 Complications
		References
	9: Dry Elbow Arthroscopy
		9.1	 Background
		9.2	 Indications
		9.3	 Surgical Technique
		9.4	 Tips and Tricks
		9.5	 Pitfalls
		References
Part III: Elbow: Instability
	10: Classification of Elbow Instability
		10.1	 Background
		10.2	 Classification
			10.2.1	 SICSeG Elbow Instability Classification
				10.2.1.1	 Simple Acute
				10.2.1.2	 Simple Recurrent
				10.2.1.3	 Simple Persistent
				10.2.1.4	 Complex Acute
				10.2.1.5	 Complex Recurrent
				10.2.1.6	 Complex Persistent
		10.3	 Summary
		References
	11: Arthroscopic Evaluation of Elbow Instability
		11.1	 Background
		11.2	 Surgical Anatomy
		11.3	 Surgical Technique
		11.4	 Pitfalls
		References
	12: Ten-Point Arthroscopic Assessment of Chronic Elbow Instability
		12.1	 Background
		12.2	 Indications and Contraindications
		12.3	 Surgical Technique
			12.3.1	 Anterior Compartment Signs
				12.3.1.1	 Traction Test: RC Distraction and Telescoping Signs
				12.3.1.2	 Anterior Radiocapitellar Drive-through Sign
				12.3.1.3	 Radiocapitellar Posterior Drawer Test
				12.3.1.4	 Varus Stress Test
				12.3.1.5	 Valgus Stress Test
				12.3.1.6	 Accessory Signs of Instability/Laxity
			12.3.2	 Posterior Compartment Evaluation and Signs
				12.3.2.1	 Ulnotrochlear Widening
				12.3.2.2	 Arthroscopic Rotatory Instability Test (Pull and Rotate)
				12.3.2.3	 Posterior Drive-Through Sign
				12.3.2.4	 Posterior Capitellar Defect (Osborne and Cotterill Lesion)
		References
	13: Arthroscopic Evaluation of Elbow Instability: An Alternative Technique
		13.1	 Background
			13.1.1	 Surgical Anatomy
		13.2	 Indications and Contraindications
		13.3	 Surgical Technique
			13.3.1	 Posterior Compartment
			13.3.2	 Anterior Compartment
		13.4	 Technical Tips
		13.5	 Pitfalls
		13.6	 Post-op Management and Rehabilitation
		13.7	 Complications
		References
	14: Arthroscopic Repair of Lateral Ulnar Collateral Ligament Injuries
		14.1	 Background
			14.1.1	 Surgical Anatomy
		14.2	 Indications/Contraindications
		14.3	 Surgical Technique
			14.3.1	 Arthroscopic LUCL Repair
			14.3.2	 Arthroscopic Plication
			14.3.3	 Open Technique
		14.4	 Tips and Tricks
		14.5	 Pitfalls
		14.6	 Postoperative Management and Rehabilitation
		14.7	 Results
		References
	15: Arthroscopic Lateral Collateral Ligament Imbrication
		15.1	 Introduction
		15.2	 Surgical Anatomy
		15.3	 Indications and Contraindications
		15.4	 Surgical Technique
		15.5	 Tips and Tricks
		15.6	 Pitfalls
		15.7	 Postoperative Management and Rehabilitation
		15.8	 Complications
		15.9	 Results
		References
	16: Arthroscopic Plication in Medial and Lateral Elbow Instability
		16.1	 Background
		16.2	 Indications and Contraindications
		16.3	 Surgical Techniques
			16.3.1	 Arthroscopically Assisted Plication of Medial Collateral Ligament
			16.3.2	 Arthroscopic R-LCL Plication
		16.4	 Postoperative Rehabilitation and Management
		References
	17: The Posterolateral Ligament of the Elbow: Surgical Anatomy, Assessment and Repair Technique
		17.1	 Background
			17.1.1	 Surgical Anatomy
		17.2	 Indications and Contraindications
		17.3	 Surgical Technique
			17.3.1	 Open PLL Repair
			17.3.2	 Arthroscopic PLL Repair
		17.4	 Tips and Tricks
		17.5	 Pitfalls
		17.6	 Postoperative Management and Rehabilitation
		17.7	 Complications
		References
	18: Lateral and Medial Elbow Instability: Graft Reconstruction Techniques
		18.1	 Background
		18.2	 Indications and Contraindications
		18.3	 Surgical Technique
			18.3.1	 UCL Reconstruction
			18.3.2	 LUCL Reconstruction
		18.4	 Tips and Tricks
		18.5	 Pitfalls
		18.6	 Postoperative Management and Rehabilitation
		18.7	 Complications
		References
	19: Arthroscopic Management of Posterior Elbow Impingement in Athletes
		19.1	 Background
			19.1.1	 Surgical Anatomy
		19.2	 Indications/Contraindications
		19.3	 Surgical Technique
		19.4	 Tips and Tricks
		19.5	 Pitfalls
		19.6	 Postoperative Management and Rehabilitation
		19.7	 Complications
		References
	20: Valgus Extension Overload
		20.1	 Background
		20.2	 Surgical Anatomy
		20.3	 Indications and Contraindications
		20.4	 Surgical Technique
			20.4.1	 Posterior Compartment
			20.4.2	 Anterior Compartment
		20.5	 Tips and Tricks
		20.6	 Pitfalls
		20.7	 Postoperative Management and Rehabilitation
		20.8	 Complications
		20.9	 Results
		References
Part IV: Elbow: Fractures
	21: Arthroscopic Approaches to Radial Head Fracture Fixation
		21.1	 Background
		21.2	 General Considerations
		21.3	 Lateral Portals
		21.4	 Medial Portals
		21.5	 Posterior Portals
		21.6	 Conclusion
		References
	22: Arthroscopic Reduction and Internal Fixation of Elbow Fractures
		22.1	 Background
		22.2	 Radial Head Fractures
			22.2.1	 Indications and Contraindications
			22.2.2	 Surgical Technique
				22.2.2.1	 Portals
				22.2.2.2	 Reduction
				22.2.2.3	 Fixation
		22.3	 Fractures of the Capitellum and Trochlea
			22.3.1	 Indications and Contraindications
			22.3.2	 Surgical Technique
		22.4	 Fractures of the Coronoid Process
			22.4.1	 Indications and Contraindications
			22.4.2	 Surgical Technique
		22.5	 Combined Radial Head and Coronoid Fractures
			22.5.1	 Indications and Contraindications
			22.5.2	 Surgical Technique
		22.6	 Postoperative Management and Rehabilitation
		References
	23: Arthroscopic Fixation of Elbow Fractures: How I Do It
		23.1	 Background
			23.1.1	 Surgical Anatomy
		23.2	 Indications and Contraindications
		23.3	 Surgical Technique
			23.3.1	 Radial Head Fractures
			23.3.2	 Coronoid Fractures
			23.3.3	 Capitellum Fractures
		23.4	 Postop Management and Rehabilitation
		23.5	 Complications
		23.6	 Results
		References
	24: Arthroscopic Fixation of Radial Neck Fractures in Children
		24.1	 Background
			24.1.1	 Surgical Anatomy
		24.2	 Indications and Contraindications
		24.3	 Surgical Technique
		24.4	 Tips and Tricks
		24.5	 Pitfalls
		24.6	 Postoperative Management and Rehabilitation
		24.7	 Complications
		References
	25: Arthroscopic Radial Head Resection Using the “Radial Head Portal”
		25.1	 Background
		25.2	 Surgical Anatomy
		25.3	 Indications and Contraindications
		25.4	 Surgical Technique
			25.4.1	 Arthroscopic Excision of an Intact Radial Head
			25.4.2	 Arthroscopic Excision of a Fractured Radial Head
		25.5	 Tips and Tricks
		25.6	 Pitfalls
		25.7	 Postoperative Management and Rehabilitation
		References
	26: Arthroscopic Fixation of Coronoid Fractures: Retrograde Wire Technique
		26.1	 Background
		26.2	 Indications and Contraindications
		26.3	 Surgical Technique
		26.4	 Tips and Tricks
		26.5	 Pitfalls
		26.6	 Postoperative Rehabilitation
		26.7	 Complications
		References
	27: Arthroscopic Fixation of Coronoid Fractures: Antegrade Wire Technique
		27.1	 Background
			27.1.1	 Surgical Anatomy
		27.2	 Indications and Contraindications
		27.3	 Surgical Technique
		27.4	 Tips and Tricks
		27.5	 Pitfalls
		27.6	 Rehabilitation Protocol
		27.7	 Complications
		References
	28: Arthroscopic-Assisted Fixation of Capitello-Trochlear Fractures
		28.1	 Background
		28.2	 Surgical Anatomy
		28.3	 Indications and Contraindications
		28.4	 Surgical Technique
		28.5	 Tips and Tricks
		28.6	 Pitfalls
		28.7	 Postoperative Management and Rehabilitation
		28.8	 Complications
		28.9	 Results
		28.10	 Summary
		References
	29: Arthroscopic Capitellum Excision and Capitelloplasty
		29.1	 Background
			29.1.1	 Surgical Anatomy
		29.2	 Indications and Contraindications
		29.3	 Surgical Technique
			29.3.1	 Arthroscopic Excision of a Comminuted Capitellum Fracture
			29.3.2	 Arthroscopic Capitellar Screw Removal and Capitellar Debridement
			29.3.3	 Arthroscopic Excision of a Capitellum Fracture Nonunion
			29.3.4	 Arthroscopic Excision of a Malunited Capitellum Fracture
			29.3.5	 Arthroscopic Excision of a Posterior Capitellum Fracture
		29.4	 Tips and Tricks
		29.5	 Pitfalls
		29.6	 Postoperative Management and Rehabilitation
		References
Part V: Elbow: Osteochondritis Dessicans
	30: Osteochondritis Dissecans of the Elbow: Concepts of Etiology
		30.1	 Background
			30.1.1	 At-Risk Factors
			30.1.2	 The At-Risk Individual
			30.1.3	 Osseous Factors: Microarchitecture
			30.1.4	 Vascular Factors and the Compartment Syndrome Model
				30.1.4.1	 Arterial Factors
				30.1.4.2	 Venous Factors
				30.1.4.3	 Intraosseous Factors
				30.1.4.4	 The Compartment Syndrome Model
		30.2	 Conclusions
		References
	31: Arthroscopic Treatment of Osteochondritis Dissecans of the Elbow
		31.1	 Background
		31.2	 Surgical Anatomy
		31.3	 Indications and Contraindications
		31.4	 Surgical Technique
		31.5	 Tips and Tricks
		31.6	 Pitfalls
		31.7	 Postop Management and Rehab
		31.8	 Complications
		31.9	 Results
		References
	32: Arthroscopic Evaluation and Management of Osteochondritis Dissecans
		32.1	 Background
			32.1.1	 Surgical Anatomy
		32.2	 Indications and Contraindications
		32.3	 Surgical Techniques
		32.4	 Results
		32.5	 Conclusions and Future Directions
		References
	33: Elbow Osteochondritis Dissecans: Arthroscopy and Reconstructive Procedures
		33.1	 Introduction
		33.2	 Surgical Anatomy
		33.3	 Indications and Contraindications
		33.4	 Surgical Techniques
			33.4.1	 Surgical Procedures
		33.5	 Technical Tips
		33.6	 Pitfalls
		33.7	 Postoperative Management and Rehabilitation
		33.8	 Complications
		33.9	 Results
		Reference
Part VI: Elbow: Epicondylitis
	34: Arthroscopic Anatomic Insertional Release (AAIR) Procedure for Refractory Lateral Epicondilitis
		34.1	 Background
			34.1.1	 Surgical Anatomy
		34.2	 Indications/Contraindications
		34.3	 Surgical Technique
		34.4	 Tips and Tricks
		34.5	 Pitfalls
		34.6	 Postoperative Management and Rehabilitation
		References
	35: Posterior Interosseous Nerve Release in Lateral Epicondylitis
		35.1	 Background
		35.2	 Surgical Anatomy
		35.3	 Indications
		35.4	 Contraindications
		35.5	 Surgical Technique
		35.6	 Tips and Tricks
		35.7	 Pitfalls
		35.8	 Post-operative Rehabilitation
		35.9	 Complications
		References
	36: Lateral Epicondylitis and Symptomatic Minor Instability of the Lateral Elbow (SMILE)
		36.1	 Background
			36.1.1	 Surgical Anatomy
		36.2	 Indications and Contraindications
		36.3	 Surgical Technique
		36.4	 Postoperative Management and Rehabilitation
		36.5	 Complications
		References
Part VII: Elbow: Arthritis and Contractures
	37: Classification of Elbow Stiffness
		37.1	 Background
		37.2	 Classification
			37.2.1	 Plane of Motion
			37.2.2	 Severity
			37.2.3	 Etiology
			37.2.4	 Prognosis
			37.2.5	 Anatomical Location
			37.2.6	 S.T.I.F. Classification
		37.3	 Treatment Algorithm
		References
	38: Arthroscopic Adhesiolysis in a Stiff Elbow
		38.1	 Background
		38.2	 Indications and Contraindications
		38.3	 Surgical Technique
		38.4	 Postoperative Management and Rehabilitation
		38.5	 Tips and Tricks
		38.6	 Pitfalls
		38.7	 Results
		References
	39: All-Endoscopic Sub-brachialis Capsulectomy for Severe Elbow Contractures
		39.1	 Background
			39.1.1	 Surgical Anatomy
		39.2	 Indications and Contraindications
		39.3	 Surgical Technique
			39.3.1	 Portals
			39.3.2	 Sub-brachialis Space Endoscopy
			39.3.3	 Radiocapitellar Joint Localization
			39.3.4	 Lateral Safe Zone Capsulectomy
			39.3.5	 Far Lateral Capsulectomy
			39.3.6	 Proximal (Supracondylar) Capsulectomy
			39.3.7	 Medial Capsulectomy
		39.4	 Tips and Tricks
		39.5	 Pitfalls
		39.6	 Post-operative Management and Rehabilitation
		39.7	 Complications
		References
	40: Arthroscopic Management of Elbow Osteoarthritis
		40.1	 Background
			40.1.1	 Surgical Anatomy
		40.2	 Indications
		40.3	 Surgical Technique
			40.3.1	 Management of Nerves
			40.3.2	 Extra-articular Posterior Band of the Medial Collateral Ligament (MCL)
			40.3.3	 Radial Head Resection
			40.3.4	 Humeral Fenestration
			40.3.5	 Capsulectomy
			40.3.6	 Microfractures and Chondroplasty
		40.4	 Postoperative Management and Rehabilitation
		40.5	 Complications
		40.6	 Conclusion
		References
	41: Arthroscopic Transhumeral Ulnohumeral Arthroplasty
		41.1	 Background
			41.1.1	 Surgical Anatomy
		41.2	 Indications and Contraindications
		41.3	 Surgical Technique
		41.4	 Tips and Tricks
		41.5	 Postoperative Management and Rehabilitation
		41.6	 Complications
		References
	42: Arthroscopic Ulnohumeral Arthroplasty
		42.1	 Background
			42.1.1	 Surgical Anatomy
		42.2	 Indications and Contraindications
		42.3	 Surgical Technique
		42.4	 Tips and Tricks
		42.5	 Pitfalls
		42.6	 Postoperative Management and Rehabilitation
		42.7	 Complications
		42.8	 Results
		References
	43: Arthroscopic Partial Radial Head Resection for Rheumatoid Arthritis
		43.1	 Background
		43.2	 Indications and Contraindications
		43.3	 Surgical Technique
		43.4	 Tips and Tricks
		43.5	 Pitfalls
		43.6	 Postoperative Management and Rehabilitation
		43.7	 Complications
		43.8	 Results
	44: Arthroscopic Releases of the Proximal Radioulnar Joint
		44.1	 Background
			44.1.1	 Surgical Anatomy
		44.2	 Indication and Contraindications
		44.3	 Surgical Technique
			44.3.1	 Arthroscopic Assessment
			44.3.2	 Arthroscopic Surgical Release
		44.4	 Tips and Tricks
		44.5	 Postoperative Rehabilitation and Management
		44.6	 Complications
		References
Part VIII: Elbow Tumour-Like Lesions
	45: Arthroscopic Transarticular Excision of Elbow Ganglion Cyst
		45.1	 Background
			45.1.1	 Surgical Anatomy
		45.2	 Indications and Contraindications
		45.3	 Surgical Technique
			45.3.1	 Portals
			45.3.2	 Diagnostic Arthroscopy and Synovectomy
			45.3.3	 Transarticular Cystoscopy
			45.3.4	 Cyst Excision
			45.3.5	 Final Assessment
		45.4	 Tips and Tricks
		45.5	 Pitfalls
		45.6	 Postoperative Management and Rehabilitation
		45.7	 Complications
		References
	46: Arthroscopic Management of Intra-articular Benign Tumours of the Elbow
		46.1	 Background
		46.2	 Indications and Contraindications
		46.3	 Surgical Technique
			46.3.1	 Portals
			46.3.2	 Osteoid Osteoma
			46.3.3	 Synovial Chondromatosis
			46.3.4	 Vascular Malformation
		46.4	 Tips and Tricks
		46.5	 Pitfalls
		46.6	 Postoperative Management and Rehabilitation
		References
Part IX: Biceps Tendon
	47: Distal Biceps Anatomy: Structural Morphometry and Dynamic Relationships
		47.1	 Background
		47.2	 Structural Anatomy of the Distal Biceps
			47.2.1	 Tendon Course and Extent
			47.2.2	 Tendon Zones and Components
		47.3	 Osseous Anatomy
			47.3.1	 Bicipital Tuberosity
			47.3.2	 Footprint Anatomy
			47.3.3	 Proximal Radioulnar Space
		47.4	 Neurovascular Anatomy
			47.4.1	 Neurovascular Relations
			47.4.2	 Neurovascular Anatomy at-Risk
			47.4.3	 Dynamic Neurovascular Relations
		References
	48: The “All-Endoscopic” Approach to Distal Biceps: Overview, Portals, and Anatomy-at-Risk
		48.1	 Background
		48.2	 Indications and Contraindications
		48.3	 Endoscopy Portals and Anatomy at-Risk
		References
	49: All-Endoscopic Management of Partial Tears of Distal Biceps Tendon
		49.1	 Background
		49.2	 Indications and Contraindications
		49.3	 Surgical Technique
			49.3.1	 Portals
			49.3.2	 Intrabursal Assessment
			49.3.3	 The “Endoscopic Probe Test” and Appearance of Partial Tears
			49.3.4	 Endoscopic Appearance of Complete Tears
			49.3.5	 Partial DBT Tear Debridement
		49.4	 Tips and Tricks
		49.5	 Pitfalls
		49.6	 Postoperative Management and Rehabilitation
		49.7	 Complications
		References
	50: All-Endoscopic Repair of Complete Retracted Distal Biceps Ruptures
		50.1	 Background
		50.2	 Indications
		50.3	 Contraindications
		50.4	 Surgical Technique
			50.4.1	 Portals
			50.4.2	 Diagnostic Endoscopy
			50.4.3	 Tendon Retrieval and Preparation
			50.4.4	 Tendon Shuttling Technique Across the Cubital Fossa
			50.4.5	 Tuberosity Preparation
			50.4.6	 Tendon Reattachment
			50.4.7	 Final Assessment
		50.5	 Tips and Tricks
		50.6	 Pitfalls
		50.7	 Postoperative Management, Rehabilitation, and Return to Sport
		50.8	 Complications
		References
	51: All-Endoscopic Autograft Augmentation and Reconstruction of Chronic Retracted Distal Biceps Tendon Tears
		51.1	 Introduction
			51.1.1	 Surgical Anatomy
		51.2	 Indications/Contraindications
		51.3	 Surgical Technique
		51.4	 Tips and Tricks
		51.5	 Pitfalls
		51.6	 Postoperative Management, Rehabilitation, and Return to Sport
		51.7	 Complications
		References
	52: Endoscopic-Assisted Onlay Repair for Distal Biceps Tears
		52.1	 Background
		52.2	 Indications and Contraindications
		52.3	 Surgical Technique
		52.4	 Tips and Tricks
		52.5	 Pitfalls
		52.6	 Postoperative Management and Rehabilitation
		References
	53: Endoscopic-Assisted Footprint Repair of Distal Biceps Tendon Ruptures
		53.1	 Background
		53.2	 Surgical Anatomy and Biomechanics
		53.3	 Indications and Contraindications
		53.4	 Surgical Technique
		53.5	 Tips and Tricks
		53.6	 Pitfalls
		53.7	 Postoperative Management and Rehabilitation Protocol
		53.8	 Results
		References
	54: Minimally Invasive Acute Distal Biceps Repair
		54.1	 Background
			54.1.1	 Surgical Anatomy
		54.2	 Indications and Contraindications
		54.3	 Surgical Technique
		54.4	 Tips and Tricks
		54.5	 Pitfalls
		54.6	 Postoperative Management and Rehabilitation
		54.7	 Complications
		References
Part X: Triceps Tendon
	55: Surgical Anatomy of the Distal Triceps Tendon
		55.1	 Introduction
		55.2	 The Triceps Muscle
		55.3	 The Triceps Tendon
		55.4	 The Distal Tendinous Insertion and Triceps Footprint
		55.5	 Surgical Considerations
		References
	56: Endoscopic Distal Triceps Repair
		56.1	 Background
			56.1.1	 Surgical Anatomy
		56.2	 Indications and Contraindications
		56.3	 Surgical Steps
			56.3.1	 Portals
		56.4	 Tips and Tricks
		56.5	 Postoperative Management and Rehabilitatiion
		56.6	 Complications
		References
	57: Acute and Chronic Triceps Tendon Tears: Transosseous Repair Technique
		57.1	 Background
			57.1.1	 Surgical Anatomy
		57.2	 Indications and Contraindications
		57.3	 Surgical Technique
		57.4	 Tips and Tricks
		57.5	 Pitfalls
		57.6	 Postoperative Management and Rehabilitation
		57.7	 Complications
		References
Part XI: Elbow: Ulnar Nerve
	58: Endoscopic Ulnar Nerve Decompression
		58.1	 Background
			58.1.1	 Surgical Anatomy
		58.2	 Indications and Contraindications
		58.3	 Surgical Technique
		58.4	 Tips and Tricks
		58.5	 Pitfalls
		58.6	 Postoperative Management and Rehabilitation
		58.7	 Complications
		References
	59: Endoscopic Ulnar Nerve Release and Transposition: Two Portal Technique
		59.1	 Background
		59.2	 Indications and Contraindications
		59.3	 Surgical Techniques
			59.3.1	 Ulnar Nerve Decompression
			59.3.2	 Anterior Transposition: Two Portal Technique
		59.4	 Postoperative Management and Rehabilitation
		59.5	 Tips and Tricks
		59.6	 Complications
		59.7	 Results
		References
	60: Endoscopic Ulnar Nerve Release and Transposition: Single Portal Technique
		60.1	 Background
		60.2	 Surgical Anatomy
		60.3	 Indications and Contraindications
		60.4	 Surgical Technique
		60.5	 In Situ Decompression
			60.5.1	 Preliminary Dissection
			60.5.2	 Distal Endoscopic Decompression
			60.5.3	 Proximal Endoscopic Decompression
			60.5.4	 Final Assessment
		60.6	 Anterior Transposition
		60.7	 Technical Tips
		60.8	 Pitfalls
		60.9	 Postoperative Management and Rehabilitation
		60.10	 Complications
		60.11	 Results
		References
	61: Endoscopic Robotic Decompression of the Ulnar Nerve
		61.1	 Introduction
		61.2	 Indications and Contraindications
		61.3	 Surgical Technique
		61.4	 Postoperative Management and Rehabilitation
		References
Part XII: Elbow Endoscopy: Evolving Techniques
	62: Endoscopic Olecranon Bursectomy and Spur Resection
		62.1	 Background
		62.2	 Surgical Anatomy
		62.3	 Indications and Contraindications
		62.4	 Surgical Technique
		62.5	 Postoperative Management and Rehabilitation
		62.6	 Complications
		62.7	 Results
		References
	63: Endoscopic Four Compartment Decompression for Chronic Exertional Compartment Syndrome
		63.1	 Background
		63.2	 Surgical Anatomy
			63.2.1	 The Lateral Mobile Wad Compartment
			63.2.2	 Dorsal Compartment
			63.2.3	 Superficial Volar Compartment
			63.2.4	 Deep Volar Compartment
		63.3	 Indications and Contraindications
		63.4	 Surgical Steps
			63.4.1	 Surface Markings
			63.4.2	 Extensor Release
			63.4.3	 Flexor Release
		63.5	 Technical Tips
		63.6	 Pitfalls
		63.7	 Postoperative Management and Rehabilitation
		63.8	 Complications
		References
	64: Endoscopic Forearm Fasciotomy: How I Do it
		64.1	 Background
		64.2	 Surgical Anatomy
		64.3	 Indications and Contraindications
		64.4	 Surgical Steps
		64.5	 Technical Tips
		64.6	 Pitfalls
		64.7	 Postoperative Management and Rehab
		64.8	 Complications
		64.9	 Results
		References
	65: Arthroscopic Management of the Painful Elbow Arthroplasty
		65.1	 Background
		65.2	 Role of Elbow Arthroscopy in TEA
		65.3	 Steps in the Management Painful Elbow Arthroplasty
		65.4	 Surgical Technique
		65.5	 Tips and Tricks
		65.6	 Pitfalls
		65.7	 Postoperative Management and Rehabilitation
		65.8	 Complications
		References
	66: Endoscopic Pronator Release (Proximal Forearm Median Nerve Decompression)
		66.1	 Background
		66.2	 Indications and Contraindications
		66.3	 Surgical Technique
		66.4	 Postoperative Care
		66.5	 Pitfalls and Complications
		66.6	 Results
		References
Part XIII: Wrist: Basic Science
	67: Functional Anatomy of the Wrist
		67.1	 Background
		67.2	 Microanatomy of the Distal Radius
			67.2.1	 The Arch Bridge Concept
		67.3	 Articulations
		67.4	 Ligaments
		67.5	 Triangular Fibrocartilage Complex (TFCC)
		67.6	 Fibro-osseous Tunnels
		67.7	 Extrinsic Extensor Tendons
		67.8	 The Volar Wrist Flexors and the ‘Pulley System’
		References
	68: Clinical Biomechanics of the Wrist
		68.1	 Introduction
		68.2	 Carpal Kinetics
			68.2.1	 Columns, Rows and Rings
				68.2.1.1	 Loading Columns
				68.2.1.2	 The Rows
				68.2.1.3	 Forearm Row
					Radius
					Ulna
					Proximal Carpal Row
					Lunate
					Scaphoid
					Triquetrum
					Distal Carpal Row
					Capitate
					Trapezium and Trapazoid
					STT Joint
					Hamate
					Pisiform
				68.2.1.4	 Ligamental Rings
				68.2.1.5	 Tendons
				68.2.1.6	 Neuromuscular Coordination
		68.3	 Carpal Kinematics
			68.3.1	 Dart Throwers Motion (DTM)
			68.3.2	 Radioulnar Deviation
			68.3.3	 Flexion and Extension
			68.3.4	 Prono-supination
			68.3.5	 Anatomic Variations Affecting Carpal Kinematics
				68.3.5.1	 Row and Column Type Wrists
				68.3.5.2	 Lunate Morphology
				68.3.5.3	 Scaphoid Kinematics
		68.4	 Carpal Instability Patterns
			68.4.1	 Dynamic Computed Tomography (4D CT)
			68.4.2	 Scapholunate Instability
		68.5	 Summary
		References
	69: Arthroscopic Equipment and Set Up for Wrist Arthroscopy
		69.1	 Background
		69.2	 Planning and Layout
		69.3	 Anaesthesia
		69.4	 Positioning
		69.5	 Equipment
		69.6	 Getting Started
		69.7	 Tips and Tricks
		References
	70: Diagnostic Arthroscopy of the Wrist: Anatomy and Portals
		70.1	 Background
		70.2	 Indications and Contraindications
		70.3	 Dorsal Anatomy for Wrist Arthroscopy
		70.4	 Dorsal Portals
			70.4.1	 Radiocarpal Space
				70.4.1.1	 1-2 and 2-2 Dorsal Portals (Fig. 70.2)
				70.4.1.2	 3-4 Dorsal Portal (Fig. 70.3)
				70.4.1.3	 4-5 Dorsal Portal (Fig. 70.4)
				70.4.1.4	 6-R Dorsal Portal (Fig. 70.5)
				70.4.1.5	 6-U Dorsal Portal (Fig. 70.5)
			70.4.2	 Midcarpal Space (Figs. 70.6 and 70.7)
				70.4.2.1	 Radial Midcarpal Portal (MC-R)
				70.4.2.2	 Ulnar Midcarpal Portal (MC-U)
		70.5	 Additional Portals
			70.5.1	 Volar Radial Portal
			70.5.2	 Volar Ulnar Portal
			70.5.3	 Distal Radioulnar Joint Portals
		70.6	 Diagnostic Arthroscopy of the Wrist
		70.7	 Diagnostic Wrist Arthroscopy: Author’s Preferred Technique
			70.7.1	 Establish Visualization and Working Portals
			70.7.2	 Diagnostic Arthroscopy: Radiocarpal Space
			70.7.3	 Diagnostic Arthroscopy: Midcarpal Space
		70.8	 Potential Complications
		References
	71: Wrist Portals and Arthroscopic Anatomy
		71.1	 Dorsal Radiocarpal Portals
			71.1.1	 1/2 Portal
				71.1.1.1	 Visualized Structures
					At the Entry Point (Fig. 71.3)
					Moving the Vision Field to the Ulnar Zone (Fig. 71.4)
				71.1.1.2	 Neurovascular Structures-at-Risk
			71.1.2	 3/4 Portal
				71.1.2.1	 Visualized Structures
					At the Entry Point (Fig. 71.6)
					Moving the Vision Field to Radial (Fig. 71.6)
					Moving the Vision Field to Ulnar (Fig. 71.7)
				71.1.2.2	 Neurovascular Structures at Risk
			71.1.3	 4/5 Portal
				71.1.3.1	 Visualized Structures
					At the Entry Point (Fig. 71.9)
					Moving the Vision Field to Radial (Fig. 71.10)
					Displacement of the Field of Vision Toward Ulnar
				71.1.3.2	 Neurovascular Structures-at-Risk
			71.1.4	 6R Portal
				71.1.4.1	 Visualized Structures
					At the Entry Point (Fig. 71.12)
					Moving the Vision Field to Radial (Fig. 71.13)
					Moving the Vision Field to Ulnar (Fig. 71.14)
				71.1.4.2	 Neurovascular Structures-at-Risk
			71.1.5	 6U Portal
				71.1.5.1	 Visualized Structures
					At the Entry Point (Fig. 71.15)
					Moving the Vision Field to Radial (Fig. 71.16)
				71.1.5.2	 Neurovascular Structures-at-Risk
		71.2	 Midcarpal Dorsal Portals
			71.2.1	 Radial Midcarpal Portal (RMC)
				71.2.1.1	 Visualized Structures
					At the Entry Point (Fig. 71.19)
					Moving the Vision Field to Radial (STT Joint) (Fig. 71.20)
					Moving the Vision Field to Ulnar (Fig. 71.21)
				71.2.1.2	 Neurovascular Structures at Risk
			71.2.2	 Ulnar Midcarpal Portal (UMC)
				71.2.2.1	 Visualized Structures
					At the Entry Point (Fig. 71.23)
					Moving the Vision Field to Radial (Fig. 71.24)
					Moving the Vision Field to Ulnar
				71.2.2.2	 Neurovascular Structures at Risk
		71.3	 Volar Portals
			71.3.1	 Volar Radial (VR) Portal
				71.3.1.1	 Visualized Structures (Fig. 71.30)
				71.3.1.2	 Neurovascular Structures at Risk
			71.3.2	 Volar Ulnar (VU) Portal
				71.3.2.1	 Visualized Structures (Fig. 71.33)
				71.3.2.2	 Neurovascular Structures at Risk
			71.3.3	 Volar Central Portal
				71.3.3.1	 Establishment of the Volar Central Radiocarpal Portal
				71.3.3.2	 Visualized Structures in the Radiocarpal Joint
					At the Entry Point
					Moving the Vision Field to Radial
					Moving the Vision Field to Ulnar
				71.3.3.3	 Establishment of the Volar Central Midcarpal Portal
				71.3.3.4	 Visualized Structures in the Midcarpal Joint
					At the Entry Point
					Moving the Vision Field to Radial
					Moving the Vision Field to the Ulnar Side
				71.3.3.5	 Neurovascular Structures at Risk
		References
Part XIV: Wrist: Scapholunate Arthroscopy
	72: Anatomy and Biomechanics of Scapholunate Ligament
		72.1	 Introduction
		72.2	 Anatomy
		72.3	 Biomechanics
		72.4	 Pathomechanics
		72.5	 Summary
		References
	73: Surgical Anatomy and Classification of Scapholunate Tears
		73.1	 Introduction
		73.2	 Surgical Anatomy
		73.3	 Surgical Technique
			73.3.1	 Radiocarpal Assessment
			73.3.2	 Midcarpal Assessment
			73.3.3	 Classification of Scapholunate Tears
		References
	74: Arthroscopic Scapholunate Ligament Thermal Shrinkage
		74.1	 Background
		74.2	 Surgical Anatomy
		74.3	 Indications and Contraindications
		74.4	 Surgical Technique
			74.4.1	 Diagnostic Arthroscopy
			74.4.2	 Arthroscopic Thermal Shrinkage
			74.4.3	 K Wire Stabilization of the Carpus
		74.5	 Tips and Tricks
		74.6	 Pitfalls
		74.7	 Postoperative Rehabilitation and Management
		74.8	 Complications
		References
	75: Arthroscopic Treatment of Scapholunate Instability
		75.1	 Background
			75.1.1	 Surgical Anatomy
		75.2	 Indications and Contraindications
		75.3	 Surgical Technique
			75.3.1	 Arthroscopic Dorsal Capsuloligamentous Repair (ADCLR)
				75.3.1.1	 Tips and Tricks
			75.3.2	 Modified Technique Using K-Wire Fixation
				75.3.2.1	 Tips and Tricks
			75.3.3	 Modified Technique in Large SL Tears with Instability: Extra-articular Distal and Proximal Capsular Repair Technique
				75.3.3.1	 Tips and Tricks
			75.3.4	 Modified Technique Using Anchors
		75.4	 Postoperative Management and Rehabilitation
		References
	76: Modified Brunelli Technique for Scapholunate Reconstruction
		76.1	 Background
		76.2	 Surgical Anatomy
			76.2.1	 Indications and Contraindications
		76.3	 Surgical Technique
		76.4	 Tips and Tricks
		76.5	 Pitfalls
		76.6	 Post-operative Management and Rehabilitation
		76.7	 Complications
		76.8	 Results
	77: Arthroscopic Ligamentoplasty for Scapholunate Instability
		77.1	 Introduction
		77.2	 Surgical Anatomy
		77.3	 Indications and Contraindications
			77.3.1	 Indication
			77.3.2	 Contraindication
		77.4	 Surgical Technique
			77.4.1	 Step 1: Bone Tunnels
				77.4.1.1	 Scaphoid Tunnel
				77.4.1.2	 Lunate Tunnel
			77.4.2	 Step 2: Preparation for Recovering the Graft
			77.4.3	 Step 3: Harvesting the FCR Tendon Graft
			77.4.4	 Step 4: Graft Passage and Fixation
				77.4.4.1	 Scaphoid Passage and Fixation
				77.4.4.2	 Lunate Passage and Fixation
			77.4.5	 Step 5: Volar Reconstruction
		77.5	 Tips and Tricks
		77.6	 Postoperative Rehabilitation
		77.7	 Complications
		References
	78: Arthroscopic-Assisted Combined Dorsal and Volar Scapholunate Ligament Reconstruction with Tendon Graft for Chronic SL Instability
		78.1	 Background
		78.2	 Indications and Contraindications
		78.3	 Operative Techniques
			78.3.1	 Patient Preparation and Positioning
			78.3.2	 Exploration of Radiocarpal Joint and Midcarpal Joint
			78.3.3	 Taking Down of Intra-articular Fibrosis
			78.3.4	 Preparation of Scaphoid and Lunate Bone Tunnels
			78.3.5	 Correction of DISI Deformity
			78.3.6	 Preparation of Lunate Bone Tunnel
			78.3.7	 Preparation of Scaphoid Bone Tunnel
			78.3.8	 Passing the Palmaris Longus Tendon Graft Through the Scaphoid and Lunate Bone Tunnel
			78.3.9	 Assessment Through Mid-carpal Joint Arthroscopy and Scapho-lunate Interval Reduction with Palmaris Longus Tendon Graft
			78.3.10	 Closure and Postoperative Care
		78.4	 Tips and Tricks
		78.5	 Postoperative Management and Rehabilitation
		78.6	 Results
		78.7	 Conclusion
		References
	79: Arthroscopic Interposition Tendon Arthroplasty for Stage-Two Scapholunate Advanced Collapse
		79.1	 Introduction
		79.2	 Surgical Anatomy
		79.3	 Indications and Contraindications
		79.4	 Surgical Steps
			79.4.1	 Diagnostic Arthroscopy
			79.4.2	 Radial Styloidectomy
			79.4.3	 Scapholunate Joint Stabilization
			79.4.4	 Tendon Interposition
		79.5	 Tips and Tricks
		79.6	 Pitfalls
		79.7	 Postoperative Rehabilitation
		79.8	 Complications
		References
	80: Arthroscopic Resection Arthroplasty for Scapholunate Advanced Collapse (SLAC Wrist)
		80.1	 Background
		80.2	 Surgical Anatomy
		80.3	 Indications and Contraindications
		80.4	 Surgical Technique
		80.5	 Tips and Tricks
		80.6	 Pitfalls
		80.7	 Postoperative Management and Rehabilitation
		80.8	 Complications
		80.9	 Results
		References
Part XV: Wrist: Scaphotrapeziotrapezoid Arthroscopy
	81: Arthroscopic Resection Arthroplasty for Scaphotrapeziotrapezoid Arthritis
		81.1	 Introduction
			81.1.1	 Surgical Anatomy
		81.2	 Indications and Contraindications
		81.3	 Surgical Technique
		81.4	 Tips and Tricks
		81.5	 Pitfalls
		81.6	 Postoperative Management and Rehabilitation
		81.7	 Complications
		81.8	 Results
		References
	82: Arthroscopic-Assisted Pyrocarbon Interposition Arthroplasty for Scapho-Trapezium-Trapezoid Joint Arthritis
		82.1	 Background
		82.2	 Surgical Anatomy
		82.3	 Indications and Contraindications
		82.4	 Surgical Technique
			82.4.1	 Portals
			82.4.2	 Distal Resection of the Scaphoid
			82.4.3	 Pyrocarbon Implant Interposition
		82.5	 Tips and Tricks
		82.6	 Pitfalls
		82.7	 Postoperative Management and Rehabilitation
		References
Part XVI: Wrist: Pisotriquetral Arthroscopy
	83: Arthroscopy of the Pisotriquetral Joint: An Overview
		83.1	 Background
		83.2	 Surgical Anatomy
		83.3	 Indications and Contraindications
		83.4	 Surgical Technique
		83.5	 Tips and Tricks
		83.6	 Pitfalls
		83.7	 Postoperative Rehabilitation and Management
		83.8	 Complications
		References
	84: Pisotriquetral Arthroscopy: Access, Evaluation, and Resection
		84.1	 Background
			84.1.1	 Surgical Anatomy
		84.2	 Indications and Contraindications
		84.3	 Surgical Technique
		84.4	 Tips and Tricks
		84.5	 Pitfalls
		84.6	 Postoperative Management, Rehabilitation, and Return to Sport
		References
Part XVII: Wrist: Distal Radioulnar Joint
	85: Surgical Anatomy of the Distal Radioulnar Joint
		85.1	 Background
		85.2	 Osseous Anatomy and Biomechanics
		85.3	 Soft-Tissue Anatomy
			85.3.1	 Triangular Fibrocartilage Complex
			85.3.2	 Interosseous Membrane
			85.3.3	 Druj Capsule
			85.3.4	 Extensor Carpi Ulnaris Tendon and Subsheath
			85.3.5	 Pronator Quadratus
		85.4	 Summary
		References
	86: DRUJ Arthroscopy: Portals and Arthroscopic Anatomy
		86.1	 Background
			86.1.1	 Surgical Anatomy
		86.2	 Indications and Contraindications
		86.3	 Surgical Technique
			86.3.1	 Prerequisites for Easier Access to DRUJ
			86.3.2	 DRUJ Portals
				86.3.2.1	 Dorsal Portals
					Proximal-DRUJ Portal (p-DRUJ) (Fig. 86.7)
					Distal-DRUJ Portal (d-DRUJ) (Fig. 86.9)
				86.3.2.2	 Ulnar DRUJ Portal: Direct Foveal (DF) Portal (Fig. 86.11) [3]
				86.3.2.3	 Volar Portals (Fig. 86.16)
					Volar DRUJ Portal (V-DRUJ) [4]
					Distal Volar DRUJ (DV-DRUJ) [5]
		86.4	 Technical Tips
		86.5	 Pitfalls
		86.6	 Postoperative Management and Rehabilitation
		86.7	 Complications
		References
	87: Arthroscopic Technique of Wafer Resection
		87.1	 Background
			87.1.1	 Surgical Anatomy
		87.2	 Indications and Contraindications
		87.3	 Surgical Technique
			87.3.1	 Traditional Technique
				87.3.1.1	 First Step: Arthroscopic Debridement of the TFCC Central Portion
				87.3.1.2	 Second Step: Arthroscopic Resection of Ulnar Head
			87.3.2	 Alternative Technique 1: Wafer Resection Through the DRUJ Preserving the TFCC
				87.3.2.1	 First Step: Portal Preparation and DRUJ Exploration
				87.3.2.2	 Second Step: Arthroscopic Resection of Ulnar Head
			87.3.3	 Alternative Technique 2: “Inverse Wafer” Resection (Wafer Resection of the Lunate and Triquetrum)
		87.4	 Technical Tips
		87.5	 Pitfalls
		87.6	 Postoperative Management and Rehabilitation
		87.7	 Complications
		References
Part XVIII: Wrist: Triangular Fibrocartilage Complex
	88: Arthroscopic Evaluation, Classification and Techniques for TFCC Tears
		88.1	 Background
			88.1.1	 Surgical Anatomy
		88.2	 Clinical Presentation
		88.3	 Imaging
		88.4	 Arthroscopic Evaluation of TFCC Tears
		88.5	 Classification of TFCC Tears
		88.6	 Techniques for Management of TFCC Tears
		References
	89: Arthroscopic Debridement of Triangular Fibrocartilage Complex Tears
		89.1	 Background
		89.2	 Indications and Contraindications
		89.3	 Surgical Technique
		89.4	 Arthroscopic Debridement as Management of TFCC Tears by their Palmer Class
		89.5	 Tips and Tricks
		89.6	 Complications
		89.7	 Summary
		References
	90: Arthroscopic TFCC Repair: Inside out Technique
		90.1	 Background
		90.2	 Surgical Anatomy
		90.3	 Indications and Contraindications
		90.4	 Surgical Technique
		90.5	 Tips and Tricks
		90.6	 Pitfalls
		90.7	 Postoperative Management and Rehabilitation
		90.8	 Complications
		90.9	 Results
		References
	91: Ligament-Specific Transosseous Foveal Repair of TFCC
		91.1	 Background
			91.1.1	 Surgical Anatomy
		91.2	 Indications and Contraindications
		91.3	 Surgical Technique
			91.3.1	 Diagnostic Arthroscopy
			91.3.2	 Creation of Transosseous Tunnels
			91.3.3	 Creation of Transosseous Tunnels
			91.3.4	 Creation of Transosseous Mattress Sutures
		91.4	 Tips and Tricks
		91.5	 Pitfalls
		91.6	 Postoperative Management and Rehabilitation
		91.7	 Complications
		References
	92: Arthroscopic-Assisted TFCC Reconstruction with Tendon Graft for Chronic DRUJ Instability
		92.1	 Background
			92.1.1	 Surgical Anatomy
			92.1.2	 Pathomechanism of TFCC Injury
			92.1.3	 Clinical Assessment of TFCC Tear
		92.2	 Indications and Contraindications
		92.3	 Surgical Technique
			92.3.1	 Set Up and Instruments
		92.4	 Tips and Tricks
		92.5	 Pitfalls
		92.6	 Postoperative Management and Rehabilitation
		92.7	 Results
		References
Part XIX: Wrist: Fractures and Dislocations
	93: Vascular Anatomy of the Scaphoid and Implications in Surgery
		93.1	 Background
		93.2	 Anatomy
		93.3	 The Extraosseous Blood Supply
		93.4	 The Intraosseous Blood Supply
		93.5	 Clinical Correlation and Implications
		References
	94: Arthroscopic Fixation of Scaphoid Fractures Using a “Scaphoid Portal”
		94.1	 Background
			94.1.1	 Surgical Anatomy
		94.2	 Indications and Contraindications
		94.3	 Surgical Technique
		94.4	 Tips and Tricks
		94.5	 Pitfalls
		94.6	 Postoperative Management and Rehabilitation
		94.7	 Complications
		References
	95: Arthroscopic Management of Scaphoid Fractures and Nonunions
		95.1	 Background
			95.1.1	 Surgical Anatomy
		95.2	 Part I: Arthroscopic-Assisted Scaphoid Fracture Fixation
			95.2.1	 Indications and Contraindications
			95.2.2	 Surgical Technique
				95.2.2.1	 Closed Reduction
				95.2.2.2	 Arthroscopic Reduction
				95.2.2.3	 Definitive Screw Fixation
				95.2.2.4	 Additional Procedures
			95.2.3	 Tips and Tricks
			95.2.4	 Pitfalls
			95.2.5	 Postoperative Management and Rehabilitation
			95.2.6	 Complications
		95.3	 Part II: Arthroscopic Bone Grafting (ABG) for Scaphoid Nonunion
			95.3.1	 Indications and Contraindications
			95.3.2	 Surgical Technique
				95.3.2.1	 Arthroscopic Evaluation
				95.3.2.2	 Debridement of Nonunion
				95.3.2.3	 Correction of Scaphoid Deformity
				95.3.2.4	 Bone Graft Through MCJ
				95.3.2.5	 Fracture Fixation
			95.3.3	 Tips and Tricks
			95.3.4	 Pitfalls
			95.3.5	 Postoperative Management and Rehabilitation
		References
	96: Arthroscopic Replacement of Proximal Pole Scaphoid Fracture
		96.1	 Introduction
		96.2	 Indications and Contraindications
		96.3	 Surgical Steps
		96.4	 Tips and Tricks
		96.5	 Pitfalls
		96.6	 Postoperative Management and Rehabilitation
		96.7	 Complications
		96.8	 Results
		Reference
	97: Minimally Invasive Fixation of Ultra-Small Proximal Pole Scaphoid Fractures
		97.1	 Introduction
		97.2	 Surgical Anatomy
		97.3	 Indications and Contraindications
		97.4	 Surgical Technique
		97.5	 Tips and Tricks
		97.6	 Pitfalls
		97.7	 Postoperative Rehabilitation and Management
		97.8	 Complications
		References
	98: Proximal Hamate Autograft for Scaphoid Fractures: Surgical Anatomy and Technique
		98.1	 Introduction
			98.1.1	 Scaphoid Anatomy
			98.1.2	 Hamate Anatomy
		98.2	 Indications and Contraindications for Hemi-Hamate Autograft
			98.2.1	 Indications
			98.2.2	 Contraindications
		98.3	 Surgical Steps
			98.3.1	 Positioning
		98.4	 Technical Tips
		98.5	 Pitfalls
		98.6	 Postoperative Management and Rehabilitation
		98.7	 Complications
		References
	99: Arthroscopic Management of Acute Perilunate Dislocations
		99.1	 Background
		99.2	 Indications and Contraindications
		99.3	 Surgical Technique
			99.3.1	 Closed Reduction
			99.3.2	 Position
			99.3.3	 Management of Grossly Unstable Perilunate Dislocations
			99.3.4	 Management of Associated Injuries in Perilunate Dislocations
			99.3.5	 Management of Associated Injuries in Perilunate Fracture-Dislocations
		99.4	 Postoperative Management and Rehabilitation
		99.5	 Tips and Tricks
		99.6	 Pitfalls
		References
	100: Arthroscopic Management of Chronic Perilunate Dislocations
		100.1	 Background
			100.1.1 Surgical Anatomy
		100.2	 Indications and Contraindications
		100.3	 Surgical Technique
		100.4	 Tips and Tricks
		100.5	 Pitfalls
		100.6	 Postoperative Management, Rehabilitation, and Return to Sports
		References
	101: Arthroscopic Management of Irreducible Volar Dislocation of the Distal Radioulnar Joint
		101.1	 Background
			101.1.1 Surgical Anatomy
		101.2	 Indications and Contraindications
		101.3	 Surgical Technique
		101.4	 Tips and Tricks
		101.5	 Pitfalls
		101.6	 Postoperative Management, Rehabilitation and Return to Sport
		References
	102: Arthroscopic Management of Distal Radius Fractures
		102.1	 Background
		102.2	 Surgical Anatomy
		102.3	 Indications and Contraindications
		102.4	 Surgical Technique
		102.5	 Tips and Tricks
		102.6	 Pitfalls
		102.7	 Postoperative Management and Rehabilitation
		102.8	 Complications
		References
	103: Minimally Invasive Plate Fixation for Distal Radius Fractures
		103.1	 Background
		103.2	 Surgical Anatomy
		103.3	 Indications and Contraindications
		103.4	 Surgical Technique
			103.4.1 Distal Approach
			103.4.2 Radial Approach
		103.5	 Technical Tips
		103.6	 Pitfalls
		103.7	 Postoperative Management and Rehabilitation
		103.8	 Results
		References
Part XX: Wrist: The Stiff Wrist
	104: Arthroscopic Arthrolysis of the Wrist
		104.1	 Background
		104.2	 Indications and Contraindications
		104.3	 Surgical Technique
			104.3.1 Radiocarpal Joint
			104.3.2 Midcarpal Joint
			104.3.3 Distal Radioulnar Joint
		104.4	 Tips and Tricks
		104.5	 Postoperative Management and Rehabilitation
		104.6	 Complications
		104.7	 Results
		104.8	 Summary
		References
	105: Arthroscopic Management of Kienbock’s Disease
		105.1	 Background
		105.2	 Initial Management
		105.3	 Arthroscopic Assessment
		105.4	 Planning Management: An Algorithm-Based Approach
		105.5	 Arthroscopic Techniques
			105.5.1 Arthroscopic Scaphocapitate Fusion
				105.5.1.1	 Indications
				105.5.1.2	 Surgical Steps
				105.5.1.3	 Tips and Tricks
				105.5.1.4	 Pitfalls
				105.5.1.5	 Post-op Management and Rehabilitation
				105.5.1.6	 Complications
			105.5.2 Arthroscopic Radioscapholunate Fusion
				105.5.2.1	 Indications and Contraindications
				105.5.2.2	 Surgical Steps
				105.5.2.3	 Tips and Tricks
				105.5.2.4	 Pitfalls
				105.5.2.5	 Post-op Management and Rehab
				105.5.2.6	 Complications
				105.5.2.7	 Results
			105.5.3	 Arthroscopic Proximal Row Carpectomy
				105.5.3.1	 Indications and Contraindications
				105.5.3.2	 Surgical Steps
				105.5.3.3	 Tips and Tricks
				105.5.3.4	 Pitfalls
				105.5.3.5	 Post-op Management and Rehabilitation
				105.5.3.6	 Complications
				105.5.3.7	 Results
		105.6	 Summary
		References
	106: Arthroscopic Limited Wrist Fusion
		106.1	 Background
			106.1.1 Surgical Anatomy
		106.2	 Indications and Contraindications
		106.3	 Surgical Technique
			106.3.1 Staging Arthroscopy
			106.3.2 Arthroscopic Capitolunate (CL) Fusion
				106.3.2.1	 Scaphoidectomy
				106.3.2.2	 Cartilage Denudation
				106.3.2.3	 Correction of Carpal Malalignment
				106.3.2.4	 Provisional Fixation of the Fusion Interval
				106.3.2.5	 Definitive Fixation
			106.3.3	 Arthroscopic Four-Corner Fusion
				106.3.3.1	 Cartilage Denudation
				106.3.3.2	 Correction of Carpal Malalignment
				106.3.3.3	 Fixation of the Fusion Interval
		106.4	 Tips and Tricks
		106.5	 Pitfalls
		106.6	 Postoperative Management and Rehabilitation
		106.7	 Complications
		106.8	 Results
		References
	107: Arthroscopic Transplantation of Osteochondral Autograft for Treatment of Cartilage Defects in the Wrist
		107.1	 Background
			107.1.1 Surgical Anatomy
		107.2	 Indications and Contraindications
		107.3	 Surgical Technique
		107.4	 Case Illustration
		107.5	 Tips and Tricks
		107.6	 Pitfalls
		107.7	 Postoperative Management and Rehabilitation
		107.8	 Complications
		107.9	 Results
		References
	108: Arthroscopic Full Wrist Fusion
		108.1	 Background
		108.2	 Indications and Contraindications
		108.3	 Surgical Technique
			108.3.1 Debride the Joint
			108.3.2 Harvest the Bone Graft
			108.3.3 Insert the Steinmann Pin
			108.3.4 Insert the Bone Graft
			108.3.5 Postoperative Management and Rehabilitation
		108.4	 Tips and Tricks
		108.5	 Pitfalls
		108.6	 Results
		References
Part XXI: Wrist: Miscellaneous
	109: Surgical Anatomy and Management of Intersection Syndrome
		109.1	 Background
			109.1.1	 Surgical Anatomy
		109.2	 Indications and Contraindications
		109.3	 Surgical Technique
		109.4	 Tips and Tricks
		109.5	 Pitfalls
		109.6	 Postoperative Management and Rehabilitation
		109.7	 Complications
		109.8	 Results
		References
	110: Arthroscopic Decompression of Intraosseous Cysts of the Lunate
		110.1	 Background
			110.1.1	 Surgical Anatomy
		110.2	 Indications and Contraindications
		110.3	 Surgical Technique
		110.4	 Tips and Tricks
		110.5	 Pitfalls
		110.6	 Postoperative Management, Rehabilitation, and Return to Sport
		References
	111: Arthroscopic Bone Graft for Lunate Ganglion
		111.1	 Background
		111.2	 Surgical Anatomy
		111.3	 Indications and Contraindications
		111.4	 Surgical Technique
		111.5	 Tips and Tricks
		111.6	 Pitfalls
		111.7	 Post-operative Management and Rehabilitation
		111.8	 Complications
		111.9	 Results
		References
	112: Arthroscopic Excision of Dorsal and Volar Ganglion Cysts
		112.1	 Background
			112.1.1 Surgical Anatomy
		112.2	 Indications and Contraindications
		112.3	 Surgical Technique
			112.3.1	 Preoperative Planning
			112.3.2 Ultrasound-Guided Volar Ganglion Methylene Blue Injection
			112.3.3 Box Theory
			112.3.4 Local Anesthesia
			112.3.5 Dry Arthroscopy
			112.3.6 Preliminary Systematic Examination
			112.3.7 Occult Dorsal Ganglion Cysts
			112.3.8 Non-occult Dorsal Intracapsular Ganglion Cysts
			112.3.9 Non-occult Dorsal Extracapsular Ganglion
			112.3.10 Volar Ganglion Cysts
		112.4	 Technical Tips
		112.5	 Pitfalls
		112.6	 Postoperative Management and Rehabilitation
		112.7	 Complications
	113: Ulnar Styloid Enthesopathy and Extensor Carpi Ulnaris Instability: Styloidectomy and Groove-Plasty
		113.1	 Background
			113.1.1	 Surgical Anatomy
		113.2	 Indications and Contraindications
		113.3	 Surgical Technique
		113.4	 Tips and Tricks
		113.5	 Pitfalls
		113.6	 Post-operative Management and Rehabilitation
		113.7	 Complications
		113.8	 Results
		References
	114: Arthrosopic Ulnar Styloidectomy for Ulnar Styloid Impaction Syndrome
		114.1	 Background
		114.2	 Surgical Anatomy
		114.3	 Indications and Contraindications
		114.4	 Surgical Technique
		114.5	 Tips and Tricks
		114.6	 Postoperative Management and Rehabilitation
		114.7	 Complications
		References
Part XXII: Hand Arthroscopy: Basic Science
	115: Portals in Hand Arthroscopy
		115.1	 Background
			115.1.1	 Surgical Anatomy
		115.2	 Trapeziometacarpal Joint Arthroscopy Portals
			115.2.1	 TMJ Portals
			115.2.2	 STT Portals
		115.3	 Metacarpophalangeal Joint Arthroscopy
		115.4	 Proximal (PIP) Interphalangeal Joint Arthroscopy
		115.5	 Distal (DIP) Interphalangeal Joint Arthroscopy
		References
Part XXIII: Carpometacarpal Arthroscopy
	116: Arthroscopic Partial Trapeziectomy for Trapeziometacarpal Arthritis
		116.1	 Background
			116.1.1	 Surgical Anatomy
		116.2	 Indications and Contraindications
		116.3	 Surgical Technique
		116.4	 Tips and Tricks
		116.5	 Pitfalls
		116.6	 Post-operative Management and Rehabilitation
		116.7	 Complications
		References
	117: Arthroscopic Complete Trapeziectomy and Suspension Arthroplasty: “Three-Steps Arthroscopic Trapeziectomy Technique”
		117.1	 Background
		117.2	 Surgical Anatomy
		117.3	 Indications and Contraindications
		117.4	 Surgical Steps
			117.4.1	 Patient Positioning
			117.4.2	 Step 1: Zone 1 Resection
			117.4.3	 Step 2: Trapezium Volar Radial Portion (Zone 2) Resection
			117.4.4	 Step 3: Trapezium Dorsal Radial Portion (Zone 3) Resection
			117.4.5	 Proximal Resection of the Trapezoid
			117.4.6	 Suture Button Suspension
		117.5	 Tips and Tricks
		117.6	 Postoperative Rehabilitation
		117.7	 Complications
		References
	118: Arthroscopic Treatment of Basal Joint Fractures
		118.1	 Background
			118.1.1	 Surgical Anatomy
		118.2	 Indications and Contraindications
		118.3	 Surgical Technique
		118.4	 Postoperative Management and Rehabilitation
		118.5	 Results
		References
	119: Arthroscopic Debridement and Metacarpal Base Osteotomy for Trapeziometacarpal Joint Osteoarthritis
		119.1	 Background
			119.1.1	 Surgical Anatomy
		119.2	 Indications and Contraindications
		119.3	 Surgical Technique
			119.3.1	 Stage 1 Treatment: Arthroscopic Debridement
			119.3.2	 Stage 2 Treatment: Basal Metacarpal Osteotomy
		119.4	 Tips and Tricks
		119.5	 Post-operative Management and Rehabiltation
		119.6	 Complications
		References
Part XXIV: Metacarpophalangeal (MCP), Proximal Interphalangeal (PIP), and Distal Interphalangeal (DIP) Joint Arthroscopy
	120: Metacarpophalangeal Joint Arthroscopy: Portals, Anatomy, and Technique
		120.1	 Background
		120.2	 Indications and Contraindications
		120.3	 Surgical Technique
		120.4	 Tips and Tricks
		120.5	 Pitfalls
		120.6	 Postoperative Management and Rehabilitation
		120.7	 Complications
		References
	121: Arthroscopic Management of Metacarpophalangeal Articular Fractures
		121.1	 Background
			121.1.1	 Surgical Anatomy
			121.1.2	 MCP Arthroscopy Indications/Contraindications
		121.2	 Surgical Technique
		121.3	 Tips and Tricks
		121.4	 Pitfalls
		121.5	 Complications
		121.6	 Post-op Management and Rehab
		121.7	 Summary
		References
	122: Arthroscopic Fixation of Metacarpal Head Fractures
		122.1	 Background
			122.1.1	 Surgical Anatomy
		122.2	 Indications and Contraindications
		122.3	 Surgical Technique
		122.4	 Tips and Tricks
		122.5	 Pitfalls
		122.6	 Postoperative Management and Rehabilitation
		122.7	 Complications
		References
	123: Arthroscopy of Proximal and Distal Interphalangeal Joints
		123.1	 Background
		123.2	 Surgical Anatomy
			123.2.1	 Proximal Interphalangeal Joint
			123.2.2	 Distal Interphalangeal Joint
		123.3	 Indications and Contraindications
			123.3.1	 PIP Joint Arthroscopy
			123.3.2	 DIP Joint Arthroscopy
		123.4	 Surgical Technique
			123.4.1	 Portals
			123.4.2	 PIP and DIP Access
			123.4.3	 Diagnostic Arthroscopy
			123.4.4	 Arthroscopic Biopsy and Synovectomy
		123.5	 Tips and Tricks
		123.6	 Pitfalls
		123.7	 Postoperative Management and Rehabilitation
		123.8	 Complications
		123.9	 Results
			123.9.1	 PIP Joint Arthroscopy
			123.9.2	 DIP Joint Arthroscopy
		References
Part XXV: Wrist and Hand Endoscopy
	124: Endoscopic Release of De Quervain’s Tenosynovitis
		124.1	 Background
		124.2	 Indications and Contraindications
		124.3	 Surgical Technique
		124.4	 Post-Operative Management and Rehabilitation
		124.5	 Complications
		124.6	 Results
		References
	125: Endoscopic Superficial Radial Nerve Decompression
		125.1	 Background
		125.2	 Surgical Anatomy
		125.3	 Indications and Contraindications
		125.4	 Surgical Technique
		125.5	 Technical Tips
		125.6	 Pitfalls
		125.7	 Post-Operative Management and Rehabilitation
		125.8	 Complications
		125.9	 Results
		References
	126: Endoscopic Carpal Tunnel Release (Supraretinacular Technique)
		126.1	 Background
		126.2	 Indications and Contraindications
		126.3	 Surgical Technique
		126.4	 Post-Operative Management and Rehabilitation
		126.5	 Results
		References
	127: Endoscopic-Assisted Tendon Transfer for Extensor Pollicis Longus Rupture
		127.1	 Background
		127.2	 Surgical Anatomy
		127.3	 Indications and Contraindications
		127.4	 Surgical Steps
		127.5	 Technical Tips
		127.6	 Pitfalls
		127.7	 Post-Operative Management and Rehabilitation
		127.8	 Complications
		References
	128: Endoscopic Trigger Finger Release
		128.1	 Background
		128.2	 Indications and Contra-Indications
		128.3	 Surgical Technique
		128.4	 Post-Operative Management and Rehabilitation
		128.5	 Complications
		128.6	 Results
		References
	129: Thenar Endoscopy: Endoscopic Excision of a Thenar Ganglion Cyst
		129.1	 Background
			129.1.1	 Surgical Anatomy
		129.2	 Indications and Contraindications
		129.3	 Surgical Technique
		129.4	 Tips and Tricks
		129.5	 Pitfalls
		129.6	 Complications
		129.7	 Postoperative Management and Rehabilitation
		References
	130: Osteoscopy for Benign Tumour Surgery in the Hand
		130.1	 Background
		130.2	 Surgical Anatomy
		130.3	 Indications and Contraindications
		130.4	 Surgical Steps
			130.4.1 Osteoscopic Enchondroma Excision
		130.5	 Technical Tips
		130.6	 Post-Operative Management and Rehabilitation
		130.7	 Complications
		Reference
Part XXVI: The Future
	131: Developing and Innovating Newer Techniques in Elbow Surgery
		131.1	 Background
		131.2	 Key Concepts for Development of a New Procedure
		131.3	 Phase 1
			131.3.1	 Rationalize
			131.3.2	 Visualize
			131.3.3	 Familiarize
		131.4	 Phase 2
			131.4.1	 Translate
				131.4.1.1	 Cadaveric Anatomy to Laboratory Trial
				131.4.1.2	 Laboratory to Operating Theatre
			131.4.2	 Evaluate
			131.4.3	 Optimize
		131.5	 Summary
		References
	132: The Future of Elbow, Wrist, and Hand Arthroscopy
		132.1	 Introduction
		132.2	 Anesthesia Techniques
		132.3	 Instrumentation and Devices
		132.4	 Dry Arthroscopy
		132.5	 Endoscopy
		132.6	 Biologics in Upper Limb Surgery
		132.7	 Conclusion
		References