Arthrodesis of the wrist in rheumatoid arthritis

Abstract

In rheumatoid arthritis the small joints of the feet and hands are the first targets of the autoimmune process. In about one half of the patient the wrist is involved in the first stages of the disease (two years) increasing up to nearly 90 percent after a decade often including both sides. Osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons. One aim of all treatment options is to achieve the best possible hand function without pain. If conservative treatment fails, operative treatment is necessary. Choice of surgical treatment depends on the soft tissue and bone situation. Techniques can be differentiated by joint preservation or joint replacement. The first include radio-synoviorthesis, synovectomy and tendon repair, the latter resection-arthroplasty, total joint arthroplasty and arthrodesis. In this paper arthrodesis of the wrist as one treatment option is reviewed.

Keywords: Arthritis, Rheumatoid, Wrist, Treatment, Surgical, Arthrodesis

Core tip: This paper discusses the pathophysiology of wrist destruction due to rheumatoid arthritis. A short overview of different treatment options is given with a special reflect on wrist arthrodesis, surgical techniques and outcomes are presented.