[Radio-lunar Mannerfelt arthrodesis in rheumatoid arthritis].
OBJECTIVE
We present data of 27 radiolunate and 23 Mannerfelt arthrodeses in patients with rheumatoid arthritis.


METHODS
Benefits of surgery, i.e. the reduction of pain, swelling, tenderness, and signs of instability as well as radiographic findings of carpal height, carpal collapse, progression of rheumatoid disease beyond the site of wrist fusion were assessed after a mean time of 44 months.


RESULTS
Wrist pain and swelling were better managed by Mannerfelt than by radiolunate arthrodesis. Average grip strength of wrists with radiolunate fusion exceeded the strength developed in wrists with Mannerfelt-fusion. However, grip strength of wrists with Mannerfelt-fusion was greater than in the opposite unfused hand, while this was not found in wrists with radiolunate arthrodesis. Postoperative improvements in hand intensive activities were more frequent in the radiolunate fusion population.


CONCLUSIONS
Advancement of carpal degeneration in radiolunate wrist fusions beyond the fusion site may indicate a rising number of symptomatic wrists with increase of follow-up time. Our results have led us to suggest radiolunate fusion for the non-dominant hand in patients with slow carpal progression of rheumatoid disease and especially if complete wrist fusion of the opposite--often dominant hand--has already been performed.
Rittmeister
M
M
Abteilung für Rheumaorthopädie der Orthopädischen Universitätsklinik Friedrichsheim der J. W. Goethe-Universität Frankfurt/Main.
Kandziora
F
F
Rehart
S
S
Kerschbaumer
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation*; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*