Arthroscopic Mobilization for Contracture of the Wrist

Purpose: We evaluated the clinical efficacy of arthroscopic mobilization of the wrist for release of persistent traumatic contracture. Methods: We retrospectively reviewed 11 consecutive patients who had undergone arthroscopic mobilization after trauma. Patients included 9 men and 2 women who ranged in age from 16 to 65 years (mean, 40 years). Injuries causing contracture included 8 fractures of the distal radius, 1 Galeazzi fracture, 1 perilunate dislocation, and 1 carpal bone contusion. A single radiocarpal septum extended from the proximal fibrocartilage of the scapholunate ligament to the midradial ridge in all but 1 patient, in whom multiple fibrous bands bridged the radiocarpal joint. Results: Arthroscopy disclosed 3 types of radiocarpal septum—a single fibromembranous structure that completely divided the joint (type A) in 9 cases, a membranous structure with a fenestration that partially divided the joint (type B) in 1 case, and multiple bands that completely divided the joint (type C); the latter situation occurred in the last patient described earlier. Preoperatively, the arc of motion averaged 76° compared with an average of 98°. Postoperatively, a 22° increase was noted. Conclusions: Arthroscopic release of a radiocarpal septum was effective in improving range of wrist motion in patients with this finding. Level of Evidence: Level IV, therapeutic case series.