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Considerations for Hand Surgery in Patients With Scleroderma.

Chelsea R Brown1, Nisha J Crouser1, Amy L Speeckaert1

  • 1The Ohio State University Wexner Medical Center, Columbus, USA.

Hand (New York, N.Y.)
|May 31, 2021
PubMed
Summary

Systemic sclerosis (SSc) presents unique hand surgery challenges due to its systemic effects. Understanding SSc pathophysiology and surgical considerations is crucial for managing hand dysfunction and improving patient outcomes.

Keywords:
Raynaud phenomenoncalcinosishand surgeryjoint contracturesclerodermasystemic sclerosis

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Area of Science:

  • Rheumatology
  • Orthopedic Surgery
  • Autoimmune Diseases

Background:

  • Systemic sclerosis (SSc), also known as scleroderma, is a complex autoimmune condition affecting multiple organ systems.
  • Musculoskeletal manifestations, particularly in the hands, significantly impact patient quality of life.
  • SSc patients often present with comorbidities, classifying them as high-risk surgical candidates.

Purpose of the Study:

  • To outline the challenges faced by hand surgeons in treating patients with Systemic Sclerosis.
  • To emphasize the importance of understanding SSc pathophysiology for surgical planning.
  • To highlight key operative considerations for optimizing hand function in SSc patients.

Main Methods:

  • Literature review of SSc musculoskeletal manifestations.
  • Analysis of surgical case studies involving SSc patients.
  • Discussion of multidisciplinary treatment approaches for SSc hand conditions.

Main Results:

  • Common hand complications in SSc include calcinosis, ischemia, Raynaud phenomenon, tendinopathies, synovitis, and contractures.
  • Multiorgan involvement in SSc increases surgical risks, necessitating careful patient evaluation.
  • Specialized surgical techniques and postoperative care are vital for managing SSc hand dysfunction.

Conclusions:

  • Hand surgeons require specialized knowledge of SSc to effectively manage hand complications.
  • Addressing systemic disease factors is paramount for successful surgical outcomes in SSc patients.
  • Improved understanding and tailored approaches can enhance hand function and patient care in Systemic Sclerosis.