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THE ROLE OF THE ARTHROSCOPY IN THE TREATMENT OF WRIST INJURIES RELATED TO SNOWBOARD PRACTICE

P. Zucco MD, G. Pezzella MD
Casa di Cura S. Carlo - Milano Italy

Upper limb injuries have increased in the last years with the growth of snowboard practice. Wrist injuries are the most common and the recent literature shows that wrist is affected by the typical snowboard injuries up to 30% of all injuries.
The wrist may be affected by many kind of fractures: fracture of the distal radius epiphysis, of the ulnar styloid (with or without radius fracture) and fracture of the carpal bones.
Furthermore very common are serious sprains with lesions of the Triangular Fibro Cartilage Complex (TFCC) or lesions of the intrarticular ligaments with a related Dorsal or Volar Intercalated Segment Instability (DISI or VISI). The lesion type 1B of the TFCC when in association with an ulnar styloid non-union may cause a Dorsal Radio Ulnar Joint (DRUJ) instability with serious funtional pain.
Thanks to the improvements of the arthroscopic technique many of these traumatic pathologies both bad outcomes of fractures or ligament's lesions can now be treated by arthroscopy.

MATERIALS AND METHOD
The Authors present a case of TFC lesion arthroscopically treated with out-in suture and a case of DRUJ instability treated with removal of the ulnar styloid bone fragment followed by TFC fixation with a Mitek anchor: all this procedure done by arthroscopy. Finally the Authors present the treatment of fractures arthroscopically assisted.

DISCUSSION AND CONLUSIONS
The Authors emphasize the role of arthroscopic treatment in the wrist pathology, both for the diagnostic and the surgical procedures like as debridment in arthrofibrosis stiffness due to fractures or dislocations, treatment of ligament's tears like TFC lesions and related DRUJ instability. In conclusion the arthroscopic treatment must be preferred in many wrist pathologies related to traumatic snowboard's injuries like dislocations, sprains or fractures.