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The correct surgical treatment of the rheumatoid wrist has an important impact on
the function of the affected band. Surgical decisions should be based on individual
deformity and poteustal progression of the disease. A classification of rheumatoid
urist involvement is presented that considers the natural progression of the disease
and helps to optimze the treatment of these pathents. If a destabilizing form of destruction
is found, limited or complete wrist fusion is often the treatment of choice. Among
partial fusions, the radiolunate arthrodesis gives consistent, good clinical results.
Is preserves some wrist motion with realignment of the carpus and stabilization to
prevent further dislocation. In cases of severe destruction and deformity, comples
wrist fusion, preferably performed by using large-pin technique, gives pain-free long-term
stability of the wrist.
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© 2002 American Society for Surgery of the Hand. Published by Elsevier Inc.
