[Radio-ulnar and radio-scaphoid-lunate arthrodesis in chronic polyarthritis. Clinical and radiologic follow-up of 32 cases].
BACKGROUND
In 75% of all cases of rheumatoid arthritis the wrist is affected and in 12% is the region of initial manifestation of this chronic inflammatory joint disease. To prevent destruction of the wrist through carpal dislocation, radiolunate and radioscapholunate arthrodeses have increased in importance.


METHODS
During a 6.5-year period, 28 radiolunate and 4 radioscapholunate arthrodeses were performed in 30 patients. The indication for operation was progressive carpal translation and increasing subluxation of the wrist in which existent radiological damage had not reached more than grade III according to the classification of Larsen and co-workers.


RESULTS
The results obtained during the follow-up study (median: 17.3 months) showed in most treated patients after partial arthrodesis of the wrist no or fewer complaints concerning swelling and pain and an acceptable remaining range of motion of the wrist in everyday life. In patients with preoperatively existing ulnar deviation less than 15 degrees progressive carpal collapse and dislocation could be mostly prevented.


CONCLUSIONS
All told radiolunate and radioscapholunate arthrodeses successfully stabilized the wrist in patients suffering from rheumatoid arthritis.
Chirurgische Klinik mit Poliklinik der Berufsgenossenschaftlichen Kliniken Bergmannsheil, Universitätsklinik der Ruhr-Universität Bochum. Stefan.A.Esenwein@ruhr-uni-bochum.de
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Esenwein
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Fritz
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Klinger
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Gaissmaier
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Martini
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Sell
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*