Thanks to wrist arthroscopy, Melanie Rappard''s got a grip. Melanie Rappard has faced medical challenges throughout her young life. The 22 year-old from Springfield, MO has Marfan syndrome, a connective tissue disease that has required multiple surgeries, including aortic heart valve repair in grade school. While a car accident in 2002 left Rappard relatively unscathed, her wrist took the brunt of the impact. And her Marfan syndrome only made repairing her wrist more difficult.

Two years worth of therapy and cortisone shots didn''t reduce the debilitating pain in her wrist. Rappard had difficulty gripping anything in her hand, making work difficult and even the simplest tasks daunting.

She searched for a second opinion and found Charles A. Goldfarb, MD, associate professor of orthopedic surgery at Washington University School of Medicine and a specialist in hand and wrist surgery at Barnes-Jewish Hospital.

"With Marfan syndrome, the patient''s tissues are abnormally weak as they lack a protein called fibrillin. I was concerned about our ability to provide a satisfactory, long-term repair which could help Melanie''s pain," says Dr. Goldfarb.

Dr. Goldfarb performed a wrist arthroscopy. Making small incisions and inserting a pencil-sized camera and instruments, Dr. Goldfarb was able to view the inside of the joint and identify specifically where the trouble was – a torn triangular fibrocartilage complex (TFCC).

"This cartilage is important for the stability of the wrist and when torn, can cause significant pain," says Dr. Goldfarb. "We were able to identify the problem with the camera and place stitches to repair the tear with quite small incisions."

"Now almost two years later, it is clear that the repair has healed and her pain has been eliminated," adds Dr. Goldfarb.

Dr Goldfarb''s expertise in wrist arthroscopy is rare in the Midwest and his experience allows the treatment of complex wrist problems with minimally invasive techniques. The types of problems that can be treated with wrist arthroscopy have expanded and include common problems such as wrist ganglions. Small incisions with minimal disruption of normal tissues provide decreased pain and a quicker recovery after surgery.

Rappard is quite happy with her outcome and has resumed all her pre-accident activities. "I had even lost the ability to grip my hand after the accident," says Rappard. "Things like just carrying a glass of water from one room to the other were things I couldn''t do. Now it''s back to normal."