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The Scleroderma Hand: Manifestations of Disease and Approach to Management

Ariel A Williams1, Hannah M Carl2, Scott D Lifchez1

  • 1Department of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, MD.

The Journal of Hand Surgery
|April 26, 2018
PubMed

Insights

Scleroderma, an autoimmune disease, causes painful hand issues like calcium deposits and digital ischemia. Careful surgical intervention offers the best solution for these challenging, disabling hand conditions.

Area of Science:

  • Rheumatology
  • Hand Surgery
  • Autoimmune Diseases

Background:

  • Scleroderma is a rare autoimmune connective tissue disease.
  • It frequently impacts the hands, causing significant morbidity.
  • Hand manifestations include calcinosis, digital ischemia, and joint contractures.

Purpose of the Study:

  • To review the surgical challenges and outcomes for scleroderma patients with hand conditions.
  • To highlight the importance of careful surgical planning in this patient population.

Main Methods:

  • Review of clinical presentations of scleroderma hand disease.
  • Discussion of surgical considerations for patients with compromised vascularity and soft tissue.

Main Results:

  • Scleroderma hand conditions present unique surgical challenges due to poor vascularity and tissue deficits.
  • Surgical intervention, when meticulously performed, can effectively manage disabling hand manifestations.
  • Complications include wound healing issues and potential for infection.

Conclusions:

  • Despite challenges, surgery is often the optimal treatment for disabling hand conditions in scleroderma.
  • Careful surgical technique and management are crucial for successful outcomes.

Keywords:
Raynaud’sSclerodermacalcinosiscontracturevasculopathy

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