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The wrist in rheumatoid arthritis
Clinical Orthopaedics and Related Research
|January 1, 1975
Summary
Rheumatoid arthritis commonly affects the wrist, leading to tendon rupture. Surgical interventions like synovectomy and tendon transfers can effectively manage wrist synovitis and prevent tendon damage in rheumatoid arthritis patients.
Area of Science:
- Orthopedics
- Rheumatology
- Hand Surgery
Background:
- The wrist is a critical upper extremity joint frequently impacted by rheumatoid arthritis.
- Rheumatoid arthritis-induced synovitis can lead to severe flexor and extensor tendon ruptures.
- Ulnar drift of the fingers is also influenced by wrist involvement.
Purpose of the Study:
- To outline surgical strategies for managing rheumatoid arthritis affecting the wrist.
- To detail methods for preventing tendon ruptures and addressing wrist deformities.
- To recommend interventions for improving wrist function and preventing further damage.
Main Methods:
- Early synovectomy to address synovitis.
- Tenosynovectomy, synovectomy, distal ulnar resection, and ligament transposition to prevent extensor tendon rupture.
- Transfer of the extensor carpi radialis longus to the extensor carpi ulnaris for ulnar deviation deficits.
- Wrist fusion for severe destruction, deformity, pain, or bilateral extensor tendon rupture.
Main Results:
- Surgical interventions effectively control synovitis and prevent tendon ruptures.
- Tendon transfers can restore active wrist ulnar deviation.
- Wrist fusion provides a stable and pain-free solution for severely damaged wrists.
Conclusions:
- Surgical management is crucial for rheumatoid arthritis of the wrist.
- Specific procedures can prevent tendon rupture and correct deformities.
- Interventions like synovectomy, tendon transfers, and fusion improve functional outcomes.