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[Rheumatoid pannus of the wrist]

J M da Costa1

  • 1Serviço de Cirurgia Plástica, Reconstrutiva e Maxilo Facial, Hospital de Santa Maria, Lisboa.

Acta Medica Portuguesa
|September 19, 1998
PubMed
Summary

Rheumatoid pannus causes destructive wrist damage, necessitating surgical intervention for joint and bone issues. This review covers surgical techniques for soft tissue and bone reconstruction in the radio-carpal and distal radio-ulnar joints.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Anatomy

Background:

  • Rheumatoid arthritis (RA) frequently affects the wrist, leading to significant joint destruction.
  • Rheumatoid pannus, an invasive inflammatory tissue, is the primary driver of RA-induced wrist pathology.
  • Damage extends to ligaments, cartilage, and bone, compromising wrist function.

Purpose of the Study:

  • To elucidate the destructive mechanisms of rheumatoid pannus in the wrist.
  • To evaluate wrist conditions requiring surgical management, focusing on the radio-carpal and distal radio-ulnar joints.
  • To review effective surgical techniques for addressing soft tissue and bone deformities in RA patients.

Main Methods:

  • Literature review of studies on rheumatoid wrist pathology and surgical interventions.
  • Analysis of biomechanical and pathological mechanisms of pannus-induced damage.
  • Synthesis of current evidence on surgical techniques for soft tissue and bone reconstruction.

Main Results:

  • Rheumatoid pannus erodes cartilage, ligaments, and bone, leading to instability and pain.
  • Surgical intervention is often required for advanced radio-carpal and distal radio-ulnar joint involvement.
  • Various techniques exist for debridement, synovectomy, tenosynovectomy, and reconstructive bone surgery.

Conclusions:

  • Understanding pannus-driven destruction is crucial for surgical planning.
  • Tailored surgical approaches are necessary for optimal outcomes in rheumatoid wrist disease.
  • Effective management involves addressing both soft tissue inflammation and skeletal deformities.

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