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Minimally invasive procedure lends a hand to wrist injuries |
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“I hit some big bumps and landed on my head and broke my back and [right] hand,” she explains. While her back eventually healed, Penny’s hand and both wrists (which were also severely damaged in the fall) would cause her tremendous grief for years to come. The pain was so intense that day-to-day activities like writing or drinking tea were out of the question and she feared her days of rock climbing and mountain biking were long gone. But they weren’t. With the help of St. Paul’s Hospital plastic surgeon Dr. Neil Wells and a minimally invasive outpatient procedure known as wrist arthroscopy, Penny, now a Whistler resident, is back in full gear. Diagnosis and treatment The beauty of wrist arthroscopy, Dr. Wells says, is that it can be used to diagnose and treat problems inside a joint. “It allows you to make a diagnosis with 100 per cent accuracy and go on and repair it at the same time.” That’s just what happened in Penny’s case. By making small incisions (less than half an inch long) Dr. Wells
inserted the pencil-sized arthroscope into Penny’s wrists.
The arthroscope contains a small lens, a miniature camera and a
lighting system which project three-dimensional images of the joint
on a Along with tears to the triangular fibrocartilage complex (TFCC) in both wrists, Dr. Wells uncovered another source of intense pain in her left hand. “I could see that she had problems with her ulnar head, which you wouldn’t be able to pick up without the arthroscope,” Dr. Wells explains. Once the diagnosis was made, he was able to then repair the TFCC tears on the spot and later shorten the ulna with a procedure known as an osteotomy. St. Paul's at forefront Presently, St. Paul’s is at the forefront in B.C. and Western Canada in wrist arthroscopy and TFCC injuries. According to Dr. Wells, the arthroscope has been used for large joints such as knees and shoulders for several years but, as cameras and instruments become smaller, it is now proving effective for smaller joints such as the wrist. That’s good news for people like Penny. Until wrist arthroscopy came along, there was no effective treatment for injuries such as hers. “Open surgery is not even an option with those types of injuries because it does so much destruction to the wrists that the benefits are lost,” says Dr. Wells. Quick recovery What’s more, recovery time with the procedure is minimal. A week following the arthroscopy, Penny returned to work. Today, at 32, she’s back on her bike and pursuing her passion for rock climbing. “Before Dr. Wells did the surgery, I couldn’t go for
20 minutes on a flat trail with my bike without having pain for
two weeks. But now I can ride all day,” she says. “And,
I’m climbing better than I ever climbed.” Triangular fibrocartilage complex The triangular fibrocartilage complex (TFCC) is made up of cartilage and ligaments that are located on the little finger side of the wrist just past the end of the forearm bone (ulna). The most common cause of a TFCC injury (and other injuries like wrist fractures) is falling onto an outstretched hand. This can result in torn ligaments or cartilage in the TFCC. Falls when mountain biking or skiing are a common cause of TFCC
injury. The symptoms are wrist pain and possibly a clicking sound
or catching sensation when the wrist is moved. |
In
July 1997 Penny Cooper suffered a traumatic mountain bike accident
in Australia’s Blue Mountains near Sydney, her hometown. |
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