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HomeReview of the conditionConsidering surgeryTypes of surgery recommended Who should consider hand surgery?What happens without surgery?Surgical options Effectiveness Urgency Risks Managing risk Preparing for surgeryAbout the procedureRecovering from surgeryRehabilitationConclusion

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Home « Clinical Services « Hand & Wrist

Hand Surgery for Rheumatoid Arthritis.

Edited By: Thomas Trumble, M.D.
Last updated Thursday, October 14, 2004

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Considering surgery

Who should consider hand surgery?

Patients who have had persistent swelling over the wrist despite medical treatment should consider having a removal of the diseased tissue. Patients with progressive deformity or increasing symptoms of pain involving the fingers or wrist also should consider surgery if the symptoms have progressed despite appropriate medical treatment.

What happens without surgery?

Once the deformity in the fingers become so severe it becomes very difficult to restore function with joint replacements. Patients with persistent swelling due to their synovitis will have tendon ruptures. Tendon ruptures result in loss of hand function, particularly in loss of the ability to extend the fingers.

Surgical options

Synovectomy with removal of the diseased tissue from the wrist joint region can be very helpful in preventing tendon ruptures. When tendons have ruptured, tendon transfers can be done to balance the hand and restore function. When there are painful joints involving either the wrist or fingers, joint replacement can help relieve pain and restore function.

Effectiveness

The surgeries can permanently improve function of the hand and prevent significant complications such as tendon ruptures.

Urgency

The most urgently needed procedures occur in patients with persistent swelling about the wrist and imminent tendon rupture. Patients with rapidly progressing deformity also should be considered for urgent surgery.

Risks

Complications are rate but can include wound infections, particularly in patients on high doses of steroids and delayed healing. When fusions are performed to stabilize joints, delayed healing can occur especially with patients with marked bone loss due to steroid use or serious bone destruction from the disease.

Managing risk

Treatment of wound infections with intravenous antibiotics can resolve most problems, and careful therapy programs can help to protect the joints and prevent excessive stress on the sites of the surgical incisions.

Surgery for arthritis of the hand at the University of Washington

If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4537 to make an appointment.

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