Long-term results after tenosynovectomy to treat the rheumatoid hand

To be effective as a prophylactic procedure, tenosynovectomy to treat rheumatoid hand has to be done before there is significant tendon damage. Tenosynovectomy is usually considered to prevent subsequent tendon rupture and recurrent tenosynovitis. We reviewed the results of all tenosynovectomies done at the Dartmouth-Hitchcock Medical Center from 1968 to 1983. One hundred seventy-three procedures were done for 125 patients. Fifty percent of patients who had prophylactic tenosynovectomy demonstrated tendon invasion. Examination at a mean of 70 months after 129 procedures showed extensor tendon failure in 1 patient of 44 who had normal tendons, 1 of 42 with invaded tendons, and in 3 of 43 who had ruptured tendons at the time of original surgery. Seven patients had recurrent tenosynovitis.