Radiographic changes after resection of the distal ulna in patients with rheumatoid arthritis

Radiographic changes in the wrist after resection of the distal ulna in 61 rheumatoid patients (63 wrists) were evaluated more than five years after operation. The wrists were classified on preoperative radiographs into stable or unstable forms as defined by Simmen and Huber. Of 63 wrists, 52 were classified as stable and the remaining 11 were classified as unstable. At follow up, 50 of 52 wrists (96%) that were stable before operation had remained stable. Five of the 11 wrists that were unstable before operation had bony ankylosis or partial radiocarpal ankylosis, and in the remaining six cases there was carpal collapse. Resection of the distal ulna yields good results in stable wrists but operation is not indicated for unstable ones.