[Hand surgery in the rheumatic hand-novel and established aspects]

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Nuclear Medicine

Background:

• Rheumatoid hand surgery has evolved significantly due to advancements in biological and biosimilar therapies.
• The impact of modern pharmacologic treatments on the progression of rheumatoid hand deformities is substantial.

Purpose of the Study:

• To review established and novel surgical procedures for rheumatoid hand treatment.
• To evaluate local interventional options within the context of modern rheumatoid hand management.

Main Methods:

• Comprehensive analysis and evaluation of existing literature.
• Incorporation of expert recommendations in the assessment of treatment strategies.

Main Results:

• Modern antirheumatic drugs slow the progression of wrist and hand destruction and deformation.
• Hand surgeons can now perform more selective procedures due to reduced disease severity.
• Established surgical techniques remain effective, with principles of biomechanics, stability, and range of motion preservation still relevant.
• Combined arthroscopic synovectomy and radiosynoviorthesis show promising results for wrist involvement.

Conclusions:

• Effective rheumatoid hand treatment requires a multidisciplinary approach involving rheumatologists, nuclear medicine physicians, and hand surgeons.
• Consistent medication, timely surgical intervention, and integrated nuclear medicine are key to preserving long-term hand function.
• This collaborative strategy enables patients to maintain the hand as a primary tool for daily activities.