Research Article: An imaging study on establishing radial volar portals using the Kiss-in method in wrist arthroscopy
Abstract:
The feasibility and safety of the Kiss-in method for VRMC and VRRC portals in wrist arthroscopy were evaluated using 3D CT reconstructions in 64 adults (32M/32F) to quantify anatomical parameters and identify gender-specific risks.
Mimics software generated 3D models of radius, ulna, carpal bones, radial artery (RA), median nerve (MN), and flexor carpi radialis (FCR). A 3.5?mm virtual trocar was inserted via the Kiss-in method; an axis-radius-aligned coordinate system enabled precise measurement of dTRA, dTMN, dTF, dTP, aTTR, aSTR, aNAT, and aNFT. A “risky zone” (?0?mm from RA/MN) was defined and analyzed.
No statistically significant differences were found between most parameters of the two portals, except for dTP and dTF. The data for dTF, dTP, aTTR in the VRMC portal, and aSTR in the VRRC portal showed statistically significant differences between genders. Female dTP values at both joints were less than the trocar's length of 45?mm. Male dTP values in the VRRC portal exceeded 45?mm in 22 cases (68.75%), and in the VRMC portal, 10 cases (31.25%). The frequency of the “risky zone” was significantly higher in the VRRC portals.
This imaging simulation study supports the theoretical feasibility of the Kiss-in method for establishing radial volar portals. The simulation results suggest potential safety benefits for the VRRC portal and indicate that the standard trocar length may be more adequate for female patients in this cohort. The determination of aTTR and aSTR has guiding significance for the practical application of the Kiss-in method.
Introduction:
Wrist arthroscopy has become a crucial technique for diagnosing and treating wrist disorders ( 1 ). Traditional palmar approach methods, such as the open operation ( 2 ), inside-out techniques ( 3 , 4 ), each have distinct advantages and limitations. For instance, the open operation requires high surgical expertise and carries a risk of neurovascular injury with a 2-cm transverse incision. The inside-out technique involves complex procedural steps. The “Kiss-in” method ( 5 ), proposed by Dr. Chen Bo, is a novel…
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