Outcomes of hand surgery in the patient with rheumatoid arthritis.
OBJECTIVE
Surgeons have long been striving to develop new surgical procedures to improve functional outcomes for a variety of hand and wrist deformities resulting from rheumatoid arthritis (RA). The purpose of this review is to assess the latest surgical outcomes related to hand and wrist surgery in the patient with RA.


RESULTS
There is a lack of outcome studies in RA hand and wrist surgery to justify many of the surgical procedures proposed for the treatment of the rheumatoid hand. However, advances made by the silicone metacarpophalangeal arthroplasty (SMPA) group regarding hand reconstruction for RA patients have improved patient care for this widely used procedure. Prophylactic versus therapeutic procedures are also discussed.


CONCLUSIONS
Rheumatoid hand is one of the earliest presentations of RA, and the progression of rheumatoid hand disease can be unpredictable. There are a number of surgical treatments for the rheumatoid hand and careful sequential planning of the surgical procedures can maintain patients' hand function and in many cases should enhance outcomes of the rheumatoid hand by correcting existing deformities. An early introduction to a hand surgeon can inform patients of available options and allow longitudinal assessment of structural and functional changes that could be treatable by future surgical interventions.
Chung
Kevin C
KC
Department of Surgery, University of Michigan Health System, Ann Arbor, 48109-0340, USA. kecchung@med.umich.edu
Kotsis
Sandra V
SV
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D050806:Arthroplasty, Replacement, Finger / Q000295:instrumentation / Q000379:methods; D042241:Early Diagnosis; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019736:Prostheses and Implants / Q000706:statistics & numerical data / Q000639:trends; D019919:Prosthesis Implantation / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D011859:Radiography; D016896:Treatment Outcome