title: Combined radiocarpal arthrodesis and midcarpal (lunocapitate) arthroplasty for treatment of rheumatoid arthritis of the wrist.
abstract: Arthroplasties for the wrist with rheumatoid arthritis are usually revised for the articulation between radius and carpus. The midcarpal joint is disregarded although it remains structurally better preserved and is therefore better suited for the preservation of stable motion. When the midcarpal surfaces are satisfactory, a radio-scapho-lunate fusion, accompanied by a midcarpal synovectomy, is an excellent procedure. When the midcarpal surfaces, particularly the head of the capitate, are also destroyed, the tendency has been to either perform a pan-arthrodesis, or to insert a wrist endo-prosthesis. For these severely unstable and destroyed wrists, a stabilization of the radiocarpal joint by arthrodesis, combined with preservation of motion at the midcarpal level by resection of the damaged head of the capitate and its replacement with a small implant has been done. This procedure has allowed all patients to retain a functional range of motion and to experience satisfactory relief of pain.
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001178:Arthroplasty / Q000379:methods*; D001696:Biomechanical Phenomena; D002348:Carpal Bones / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011884:Radius / Q000601:surgery; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery*