[Gout - a surgical problem]

The incidence of gout has increased in recent years. For effective treatment an interdisciplinary approach is necessary. Medical therapy can be effectively supported by surgical removal of the tophi. This way normalisation of the uric-acid-pool can be achieved more quickly without additional harmful effects on the kidneys. Especially in the area of the hand surgical extirpation of the tophi can be gratifying, though it may be a difficult task. Severe restrictions in function of the hand can be corrected. This is demonstrated by the case of a 56 year old patient.