Arthroscopic Management of Dorsal Capsular Lesions

Various authors have cast light on the importance of the dorsal radiocarpal ligament (DRCL) in maintaining carpal stability. In most series, the DRCL is overlooked since it is hard to visualize a DRCL tear through the standard dorsal wrist arthroscopy portals. Wrist arthroscopy through a volar radial portal is the ideal way to assess the dorsal radiocarpal ligament due to the straight line of sight. An isolated DRCL tear can be a cause of chronic wrist pain and is effectively treated with an arthroscopic repair. Dorsal wrist ganglia can also be safely removed arthroscopically with similar recurrence rates to open techniques. A volar portal allows direct visualization of the ganglion during an arthroscopic resection which can aid in preventing extensor tendon injuries.