Arthroscopic release for Wrist Stiffness

Introduction

Wrist stiffness is a common complication of trauma or surgery to the wrist. A wrist is stiff when the functional range cannot be achieved. It may cause significant disability during daily self-care. 

Aetiology

The origin of the stiffness can be extra-articular, intra-articular or both. Intra-articular causes include arthrofibrosis and capsular contracture. Extra-articular causes included skin contracture, tendon adhesion, etc.

Prevention

Good rehabilitation after trauma or surgery is the key to preventing wrist stiffness. Reasonable oedema control and adequate pain management are crucial. Early mobilisation is essential to avoid stiffness. Medication, such as oral leukotriene receptor antagonists, is still under clinical trial. 

Management of Wrist Stiffness

The patient shall be re-evaluated for a detailed history, complete physical examination and appropriate investigation. The initial magnitude of trauma and the management method are critical cues for the aetiology. It is of utmost importance to differentiate intrinsic and extrinsic causes of the stiffness, and one must never forget both can be present together. The intra-articular origin of the wrist contracture can be managed by removing the radiocarpal spectrum and capsular release. The literature has shown good range improvement by arthroscopic release with good post-operative rehabilitation.