title: Does wrist fusion cause destruction of the first carpometacarpal joint in rheumatoid arthritis? 18 patients followed for 2-6 years.
abstract: We evaluated radiographic destruction of the first carpometacarpal joint (CMC I) in 18 hands with wrist fusions and compared it with the unoperated contralateral hands preoperatively and after a follow-up of a mean of 4.4 (2-6) years. Patients were obtained from a prospective 20-year follow-up study of 103 patients with seropositive rheumatoid arthritis. The degree of destruction in the CMC I-joints was evaluated with Larsen grades. The mean value of Larsen indices for CMC I was 0.9 before wrist fusion and 2.5 (p < 0.001) at the follow-up, compared to 0.8 and 1.3 (p = 0.06) in the control hands, respectively. No preoperative difference was found between the hands to be fused and the control hands, but the difference was significant (p = 0.009) after the follow-up.
authors.affiliation: Rheumatism Foundation Hospital, Helnola, Finland.
authors.forename: E A
authors.initials: EA
authors.lastname: Belt
authors.forename: K
authors.initials: K
authors.lastname: Kaarela
authors.forename: H J
authors.initials: HJ
authors.lastname: Kautiainen
authors.forename: M J
authors.initials: MJ
authors.lastname: Kauppi
authors.forename: M U
authors.initials: MU
authors.lastname: Lehto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000473:pathology*