الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The use of arthroscopy in management of ulnar sided wrist pain has been developed in last few years to be an acceptable method of management of this problem which has been considered the black box of the wrist, which affects daily activity of the patient as regarding pain and decreased hand grip and range of motion.
The causes of ulnar side wrist pain may be extra-articular or intra-articular causes; Intra-articular ulnar side wrist pain can be classified into three categories: ulnocarpal pain, distal radioulnar pain and pisotriquetral pain. The differential diagnosis of ulnar sided wrist pain can be divided into six anatomical elements: osseous, ligamentous, tendinous, vascular, neurologic, and miscellaneous.
Diagnosis of ulnar side wrist pain depends on history taking; clinical examination of the patient and investigations (pain x ray, CT scan, MRI, ultrasound, EMG and nerve conduction velocity) but the wrist arthroscopy remains the gold standard test for the diagnosis and treatment of ulnar side wrist pain.
In our study forty eight patient with ulnar sided wrist pain with full examination, investigations and preoperative assessment with wrist scores (VAS, quick DASH and Mayo wrist score) were managed with wrist arthroscopy.
In our study we had 22 patient with TFCC injuries with or without DRUJ instability or un united ulnar styloid ,of which we had 4 patient with Palmar IA TFCC injuries treated with arthroscopic debridement and synovectomy, 5 patient with Palmar IB treated with arthroscopic repair ,one patient with Palmar ID treated with trans-osseous repair ,2 cases with massive TFCC tear and DRUJ instability treated with DRUJ ligament reconstruction with palmaris tendon graft (Adams operation), 4 cases with un united ulnar styloid fracture and unstable TFCC (3 cases treated with fixation with tension band technique and one case treated with excision of the sclerosed styloid and re insertion of TFCC with soft tissue anchor).we had 6 cases of degenerative TFCC injuries Palmar II A,B,C treated with arthroscopic synovectomy debridement and drilling of articular ulcers if present.
In our study we had also 19 cases of Kienböck’s disease in different stages that had been managed according to Bain and Begg articular based approach with arthroscopy or assisted arthroscopy with added open surgical intervention, 2 cases in stage I and stage II treated with arthroscopic synovectomy and extra articular radial shorting osteotomy with small DCP plate one case lunate collapse progress stage II and case in stage I improved with no collapse ,13 cases in stage III treated with arthroscopic scaphocapitate fusion with iliac bone graft and one case lunate excision and fixation with one or two Herbert screws with rapid healing than open surgery and minimal invasive technique. We had 4 cases of Kienböck’s in stage IV in one of them assisted arthroscopic proximal row carpictomy had done and total wrist arthrodesis had done in 3 cases.
There were 7 cases of impaction syndrome, one case ulnar styloid impaction partial ulnar styloidictomy had done, 6 cases of ulnar impaction syndrome in one of them ulnar shorting osteotomy had done with use of small DCP plate and 5 cases arthroscopic Wafer operation had done.
Arthroscopic management is a good option for management of ulnar side wrist pain with promising functional results. Post-operative flexion-extension range, grip, VAS and MMWS improved significantly with minimal invasive technique and less complications.