Reconstruction of the rheumatoid thumb.
Thumb deformities are common manifestations of rheumatoid arthritis and represent a significant source of disability. A clear understanding of the pathophysiology of the disease is essential in directing treatment. Differential diagnosis for flexible deformities includes soft-tissue imbalances as well as tendon ruptures. In its early stages, thumb involvement can be treated nonsurgically or with soft-tissue reconstruction. With more advanced disease, arthrodesis and arthroplasty often are required. Isolated interphalangeal involvement is best addressed with arthrodesis. Metacarpophalangeal involvement can be treated with arthroplasty in low-demand patients or with arthrodesis in more active patients. Trapezium resection arthroplasty provides excellent relief for patients with carpometacarpal joint destruction.
Rozental
Tamara D
TD
Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006227:Hand Deformities, Acquired; D006801:Humans; D019637:Orthopedic Procedures; D013933:Thumb