Wrist tuberculosis-experience from eighteen cases: a retrospective study.

Area of Science:

• Orthopedics
• Infectious Diseases
• Rheumatology

Background:

• Wrist tuberculosis is a rare condition often misdiagnosed, leading to delayed treatment and poor prognosis.
• This study retrospectively analyzes 18 cases to understand clinical features, diagnosis, treatment, and outcomes.

Purpose of the Study:

• To evaluate the effectiveness of surgical and chemotherapeutic interventions for wrist tuberculosis.
• To identify factors contributing to successful treatment and functional recovery.

Main Methods:

• Retrospective analysis of 18 patients diagnosed with wrist tuberculosis between 2013 and 2018.
• Diagnosis confirmed by puncture biopsy; treatment involved surgery (focus removal or wrist fusion) and chemotherapy.
• Outcomes assessed using Gartland and Werley scores, DASH scores, range of motion, grip strength, and imaging.

Main Results:

• All patients completed chemotherapy with normal inflammatory markers (ESR, CRP) and no recurrence during follow-up (average 39.7 months).
• Focus removal group showed significant improvement in functional scores (Gartland and Werley, DASH) and wrist function (ROM, grip strength).
• Wrist fusion cases had generally good fixation, with one instance of slight deformity.

Conclusions:

• Early diagnosis and a combined approach of chemotherapy and surgical intervention are crucial for managing wrist tuberculosis.
• Thorough debridement and appropriate limb fixation aid in functional restoration and minimizing recurrence.
• Optimized treatment strategies improve the quality of life for patients with wrist tuberculosis.