Realignment stabilization synovectomy in the rheumatoid wrist. A study of twenty-five cases.
The authors studied a series of 25 rheumatoid wrists, stages II and III according to Steinbrocker or Larsen, treated between 1981 and 1983 by realignment-stabilization synovectomy. The mean follow-up period was 2 1/2 years. The different steps of the operation--articular and tenosynovectomy, tendon transfers associated with dorsal ligamentoplasty--have an additive effect in achieving relief of pain, with preservation of the pre-existing mobility and long-term stability in both the frontal and sagittal planes. In other studies, resection of the ulnar head results in a 40 p. cent increment in instability with notably aggravation of ulnar sliding. Preservation of the distal radioulnar articulation according to Sauve-Kapandji's operation constitutes a new approach to rheumatoid arthritis and, in our opinion, appears to be simple and is very efficient in stabilizing the wrist immediately, thus allowing early rehabilitation of these patients. Long-term stability is affirmed by clinical and roentgenologic follow-up.
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D011859:Radiography; D000074402:Synovectomy; D014955:Wrist Joint