Journal List > J Korean Soc Surg Hand > v.18(4) > 1106445

J Korean Soc Surg Hand. 2013 Dec;18(4):196-205. Korean.
Published online December 27, 2013.  https://doi.org/10.12790/jkssh.2013.18.4.196
Copyright © 2013. The Korean Society for Surgery of the Hand
Current Concept of Surgical Management for Rheumatoid Arthritis of the Wrist
Sung Jong Woo and Min Jong Park
Deparment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Min Jong Park. Deparment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. TEL: +82-2-3410-3506, FAX: +82-2-3410-0061, Email: mjp3506@skku.edu
Received November 10, 2013; Revised December 10, 2013; Accepted December 12, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Rheumatoid arthritis is a systemic inflammatory disorder inducing multiple joint destruction. The wrist joint is frequently involved in early stage and proper management can preserve the ability to maintain a daily living and to work. Advances in medical treatment modalities can halt most joint destruction, however, not in all instances of joint inflammation and deformities. Most patients want to improve their own functional disability, pain, aesthetic problems in addition to medication. We review the current concept of rheumatoid wrist surgery and discuss the surgical treatment strategies for optimizing outcomes for patients with rheumatoid wrist.

Keywords: Rheumatoid arthritis; Wrist; Surgical treatment

Figures


Fig. 1
(A) Arthroscopic synovectomy of the wrist rheumatoid arthritis. (B) Intraoperative arthroscopic photographs demonstrating diffuse synovectomy of the wrist joint, and (C) subsequent removal of the synovium.
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Fig. 2
(A) Intraoperative photographs demonstrating extensive extensor tenosynovitis with synovitis and (B) subsequent open synovectomy of the dorsal wrist joint.
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Fig. 3
(A) Postoperative X-ray of Darrach procedure, (B) matched resection arthroplasty, and (C) hemiresection interposition arthroplasty.
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Fig. 4
(A) Sauvé-Kapandji procedure. (B) An asterix indicate a compression screw for the distal radioulnar joint arthrodesis, and white arrow and black arrow demonstrate pseudoarthrosis and extensor carpi ulnaris tenodesis, respectively.
Click for larger image


Fig. 5
Radiocarpal partial arthrodesis in rheumatoid wrist. (A) Preopertative and (B) postoperative radiographs.
Click for larger image

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