Tiến sĩ Papp IS Trợ lý Giáo sư, Đại học Ottawa, Bệnh viện Ottawa Civic, Ottawa, ON, Canada. Tiến sĩ Athwal IS Trợ lý Giáo sư, Đại học Western Ontario, tay và Upper Limb Trung tâm, chăm sóc sức khỏe của Thánh Giuse, London, ON. Tiến sĩ IS Pichora Chủ tịch, Phòng Phẫu thuật chỉnh hình, | rhe Rheumatoid Wrist Steven R. Papp MD MSc FRCSC George S. Athwal MD FRCSC David R. Pichora MD FRCSC Dr. Papp is Assistant Professor University of Ottawa Ottawa Civic Hospital Ottawa ON Canada. Dr. Athwal is Assistant Professor University of Western Ontario Hand and Upper Limb Centre St. Joseph s Health Care London ON. Dr. Pichora is Chairman Division of Orthopedic Surgery and Hand Fellowship Director Queen s University Kingston General Hospital Kingston ON. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article Dr. Papp Dr. Athwal and Dr. Pichora. Reprint requests Dr. Papp Ottawa Civic Hospital Room 2-018 1053 Carling Avenue Ottawa ON Canada K1Y4E9. J Am Acad Orthop Surg 2006 14 65-77 Copyright 2006 by the American Academy of Orthopaedic Surgeons. Abstract Wrist involvement is common in patients with rheumatoid arthritis. Individual patient assessment is important in determining functional deficits and treatment goals. Patients with persistent disease despite aggressive medical management are candidates for surgery. Soft-tissue procedures offer good symptomatic relief and functional improvement in the short term. Extensor and flexor tendons may rupture because of synovial infiltration and bony irritation. When rupture occurs direct repair usually is not possible. However when joints that are motored by the ruptured tendon are still functional tendon transfer or grafting may be considered. Because of the progressive nature of the disease dislocation and endstage arthritis often require stabilization with bony procedures. The distal radioulnar joint is usually affected first and is commonly treated with either the Darrach or the Sauvé-Kapandji procedure. Partial wrist fusion offers a compromise between achieving stability of the affected radiocarpal joint and maintaining motion at the .
