Preventive surgery - tenosynovectomy and synovectomy.

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Hand Surgery

Background:

• Rheumatoid arthritis commonly affects the hand, leading to synovitis and tenosynovitis.
• Untreated synovitis can cause irreversible joint damage and tendon rupture.
• Preventative surgery aims to mitigate these destructive processes.

Purpose of the Study:

• To review the indications for synovectomy and tenosynovectomy in rheumatoid hand disease.
• To describe surgical techniques for dorsal and flexor tenosynovectomy.
• To outline the management of extensor and flexor tendon ruptures.

Main Methods:

• Literature review of surgical procedures for rheumatoid hand disease.
• Discussion of indications and contraindications for synovectomy and tenosynovectomy.
• Description of surgical techniques for wrist, palm, and digit tenosynovectomy.

Main Results:

• Dorsal and flexor tenosynovectomy are established procedures for preventing tenosynovitis complications.
• The efficacy of synovectomy alone is less definitively established.
• Surgical techniques for various locations and tendon rupture management are presented.

Conclusions:

• Early surgical intervention, including tenosynovectomy, is crucial in managing rheumatoid hand disease.
• Further research may clarify the role of synovectomy in specific rheumatoid hand conditions.
• Comprehensive surgical management addresses both tenosynovitis and tendon ruptures.