Opera-glass hand in rheumatoid arthritis

Area of Science:

• Orthopedics
• Rheumatology
• Hand Surgery

Background:

• Rheumatoid arthritis frequently leads to characteristic deformities in the hand, known as opera-glass hand.
• These deformities involve the fingers, thumb, and wrist, resulting in bone resorption, dislocation, digital shortening, and instability.
• The condition can be severely disabling, significantly impacting hand function.

Purpose of the Study:

• To review the characteristic deformities of the opera-glass hand in rheumatoid arthritis.
• To discuss surgical strategies for functional improvement and length restoration.
• To highlight the role of early intervention and prophylactic measures.

Main Methods:

• Review of characteristic deformities in opera-glass hand associated with rheumatoid arthritis.
• Analysis of surgical interventions including interphalangeal joint arthrodesis, metacarpophalangeal prosthetic arthroplasty, and interposition grafts.
• Consideration of early spontaneous fusion and prophylactic arthrodesis.

Main Results:

• Early spontaneous fusion of proximal interphalangeal joints can preserve digital length.
• Interphalangeal joint arthrodesis and metacarpophalangeal prosthetic arthroplasty improve finger function.
• Metacarpophalangeal and/or interphalangeal arthrodesis can improve thumb function.
• Interposition grafts are often necessary with interphalangeal arthrodesis to restore length and ensure fusion.

Conclusions:

• Surgical management, including arthrodesis and prosthetic arthroplasty, offers functional improvement for opera-glass hand in rheumatoid arthritis.
• Early recognition of imminent bone resorption may warrant prophylactic arthrodesis of interphalangeal joints.
• Restoring digital length and stability is crucial for mitigating disability.