Late results of synovectomy of wrist, MP and PIP joints. Multicenter Study

Böhler, N.; Lack, N.; Schwägerl, W; Sollermann, Ch.; Teigland, Jens; Thabe, H.; Tillmann, K.

doi:10.1007/bf02032313

Cited by 25 publications

(8 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Zahlreiche Arbeiten berichten nach Frühsynov-ektomie des rheumatischen Handgelenkes (1,5,32,34,39) über eine zuverlässige Schmerzreduktion zwischen 70 und 80%. Die erwünschte Stabilisierung der dorsalen Handgelenkskapsel mit Subkutanverlagerung der Strecksehnen führt zu einer Reduktion der Extensions-Flexions-Ebene von durchschnittlich 30%.…”

Section: Diskussionunclassified

See 1 more Smart Citation

Die radioulnäre Teilarthrodese zur Stabilisierung des rheumatischen Handgelenkes

Schill

Lühr²,

Thabe³

2002

Zeitschrift f�r Rheumatologie

Self Cite

View full text Add to dashboard Cite

Late Synovectomy of the rheumatoid wrist combined with ulna head resection and dorsal wrist stabilization will not prevent carpal instability and dislocation. Depending on the radiological destruction pattern and the natural course of the wrist according to Simmen, dorsal wrist synovectomy is combined with soft-tissue or osseus stabilization procedures.This article describes the mid- and long-term results of radio-lunate arthrodesis in patients with rheumatoid arthritis. We present a retrospective study of 69 radiolunate arthrodesis performed from 1988 to 1994. Fifty patients with 57 wrists were available for clinical and radiological follow-up. All patients were suffering from rheumatoid arthritis (dominating female). The average length of R.A. illness was 9.6 years. The mean age at operation was 54.4 years. Postoperative results were reviewed with the Clayton score. The radiographic analysis included measurement of the carpal height index and ulnar translation of the carpus. The follow-up period ranged from 4 to 10.8 years (average: 7 years). The postoperative Clayton score averaged 74.2 points, representing 70% good or excellent results. Twelve wrists achieved satisfactory results and five were judged poor. The most benefit was achieved in pain relief and restoration of wrist function and extensor strength. Complete pain relief was achieved in 36 wrists, while 16 reported slight pain from loads. Five patients still complained about pain with daily wrist activity. We noticed a moderate decrease for extension-flexion (-39 degrees ) and for combined ulnar-radial deviation (-10 degrees ). The radiographic analysis proved stabilization of ulnar translocation in most cases. We routinely noticed a moderate radiographic progression according to the Larsen classification (+0.7) with reduction of the carpal height ratio. In conclusion radioulnate arthrodesis proved satisfactory pain relief and maintenance of functional wrist motion. Despite radiographic deterioration, partial wrist arthrodesis restrains ulnar translocation, while stabilization of the rheumatoid wrist is achieved.

show abstract

Section: Diskussionunclassified

“…In der Literatur (1,4,5,18,21,35) wird mittel-und langfristig eine sehr gute Schmerzreduktion (74-95%) mit Verbesserung der Handgelenksfunktion dokumentiert. Kritisch bewertet werden muss die postoperative Ulnardrift und Rotationsinstabilität des Karpus nach Ulnaköpfchen-resektion.…”

Section: Introductionunclassified

Die radioulnäre Teilarthrodese zur Stabilisierung des rheumatischen Handgelenkes

Schill

Lühr²,

Thabe³

2002

Zeitschrift f�r Rheumatologie

Self Cite

View full text Add to dashboard Cite

show abstract

“…Good results have been reported from several centers, mainly in Scandinavia [10,17,18,22]. Several studies have shown that the operation can effectively reduce inflammatory symptoms in a joint, but no scientific evidence shows that synovectomy prevents progressive joint destruction [1,2,5,9,15,21,23]. In recent years, the administration of locally acting cortisone agents to the inflamed joint has partly replaced surgical synovectomy, which now is usually performed concurrently with other interventions in the joint.…”

Section: Arthrosynovectomy (Removing Inflamed Synovial Membrane)mentioning

confidence: 99%

Surgical treatment--general opinions

2000

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…Surgical results following synovectomy vary, usually the flexion-extension mobility of the wrist becomes worse, while the rotational ability usually improves, particularly if ulnar head resection or another intervention in the DRU joint is performed concurrently [3,4,35,58,59]. Long-term studies have shown rather good pain relief, even 8 to 12 years after the operation, while progressive rheumatic destruction of the joint does not seem to be affected by synovectomy [9,60]. Use of potent long-acting steroids in injection treatment of rheumatic synovitis has reduced the need for surgical synovectomy.…”

Section: Arthro/synovectomymentioning

confidence: 99%

The wrist

2000

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Rheumatoid arthritis often causes symptoms in the wrist; pain and deformity affect the function of the entire hand and predispose deformity of the fingers.Preventive surgery, ie, synovectomy, joint stabilization, and resection of the ulnar head may decrease pain, correct deformity, and avoid tendon ruptures in the hand.If rheumatic disease has destroyed the wrist, total or partial arthrodesis (fusion) is an appropriate way to achieve stabilization and pain relief.Currently, there is no wrist endoprosthesis available which offers practical and reliable long-term results.The data in this chapter are based mainly on retrospective clinical and radiological studies in rheumatic patients. AnatomyThe wrist is a complex, anatomic structure including multiple joints among the long bones of the forearm (radius and ulna) and the eight bones of the wrist (carpal bones). The wrist can be divided into three different joint systems:Distal radioulnar joint (DRU joint). Together, the DRU joint and the proximal radioulnar joint of the elbow enable rotation of the forearm, ie, pronation (downward rotation) and supination (upward rotation) of the arm.The radiocarpal joint. The actual wrist between the joint surface of the radius and the first row of carpal bones. Approximately half of the upward and downward mobility of the wrist takes place in this joint.The intercarpal joints. The wrist (carpus) consists of eight carpal bones that articulate with each other, involving complex biomechanics. Approximately half of the upward and downward mobility of the wrist takes place in the joints between the The wrist first and second rows of carpal bones. The ability of the wrist to move sideways (radial-ulnar deviation) depends on the mobility in the intercarpal joints.

show abstract

Late results of synovectomy of wrist, MP and PIP joints. Multicenter Study

Cited by 25 publications

References 3 publications

Die radioulnäre Teilarthrodese zur Stabilisierung des rheumatischen Handgelenkes

Die radioulnäre Teilarthrodese zur Stabilisierung des rheumatischen Handgelenkes

Surgical treatment--general opinions

The wrist

Contact Info

Product

Resources

About