[The rheumatoid wrist. Pathobiomechanics and therapy]

Area of Science:

• Orthopedics
• Rheumatology
• Hand Surgery

Background:

• A stable, pain-free wrist is crucial for hand function.
• Rheumatoid disease rapidly affects the wrist joint, making early operative treatment important.
• Surgical intervention is indicated for established osseous changes, instability, deformities, tendon ruptures, and drug-resistant synovitis or monarthritis.

Purpose of the Study:

• To review operative treatment options for rheumatoid wrist disease.
• To emphasize the importance of selecting procedures based on disease stage and patient needs.

Main Methods:

• Review of available surgical procedures for rheumatoid wrist disease.
• Consideration of factors influencing surgical choice: disease type, stage, pathobiomechanics, and patient-specific factors.

Main Results:

• A range of surgical procedures exists, including synovectomy, ulna head resection, partial/complete arthrodesis, and arthroplasty.
• Tailoring the surgical approach to individual patient conditions is key to successful outcomes.

Conclusions:

• Appropriate surgical management can preserve wrist stability and function for extended periods.
• Even with limited mobility, functional outcomes can be achieved in rheumatoid wrist disease.