Handgelenksarthrodese bei chronisch-entzündlichen Gelenkerkrankungen*

Abstract

Arthrodesis of the wrist joint in patients with rheumatoid arthritis is restricted to extreme changes combined with osseous destruction, luxation and wrist instability. Multiple ruptures of the extensor tendons of the fingers may also necessitate artificial ankylosis. The authors employ plate osteosynthesis according to the official AO prescription (»Arbeitsgemeinschaft für Osteosyntheses«). This enables early functional exercise treatment. The wrist joint is adjusted in an approximately neutral position with slight ulnar deviation. Between 1.7.74 and 30.6.84, 22 arthrodeses of the wrist joint were performed in 20 rheumatic patients at the Orthopaedic Hospital of the BRK Rheuma Centre at Bad Abbach; on the whole, 294 surgical interventions were performed during this period at the wrist joint extensor side in rheumatic patients. 9 patients with 11 arthrodeses of the wrist joint were followed up, partly after years. All patients were satisfied with the result of the operation - some of them were even highly satisfied - and were thus able to look after themselves (with particular reference to hygienics) and to regain independence of helpers.