Basics of Surgery for Arthritis.
Last updated Thursday, December 30, 2004
Hand and wrist surgerySurgery is one option The loss of hand function is a serious matter, especially when the hands are also painful.
When other therapy has not helped enough to allow you to do
necessary tasks, such as holding a fork or zipping clothing, surgery
may be the answer. In addition, some people with arthritis are
concerned about deformity in their hands. While surgery may improve the
look of the hands, remember that the main purposes of surgery are to
decrease severe pain and to restore function.
Surgical options for the hand and wrist There are several types of operations that are performed on the
hands and wrists: tendon repair, synovectomy, joint replacement, and
arthrodesis.
People with hands that are severely affected by rheumatoid arthritis
may develop dorsal tenosynovitis. This condition involves the long
tendons on the back of the hand ("dorsal"-back; "teno"-tendon;
"synovitis"-inflammation of the synovial membrane). This problem
produces a soft lump that is painless. The affected tendon, however,
sometimes tears so that a finger cannot be moved. The surgery to repair
the tendon is usually successful. Recovery is made within a few weeks.
The surgery--which is often done before the tendon ruptures--is a very
important part of the treatment for some people with rheumatoid
arthritis.
Sometimes surgery is done to tighten tendons that are too loose or
to loosen tendons that are too tight. This type of surgery improves the
function of the hands and fingers. Often a deep ligament may need
loosening to correct carpal tunnel syndrome.
Excess synovial tissue can be removed from the wrists and fingers.
Synovectomy helps relieve pain and prevent deformity. It is done mainly
in the early stages when deformity is not too great.
Deformity itself doesn't always hinder the function of the hand as
much as you might think. However, when hand and finger deformity is
very painful and has not been helped by rest, injections, medication,
exercise, and splinting, replacement of the finger joints can be done.
When there is pain in the wrist, several procedures may be
considered. Arthrodesis limits movement, but it produces excellent
relief of pain and more stability for some hand joints. Resection of
one of the wrist bones may improve motion, reduce pain, and prevent
future tendon ruptures. Wrist joint replacement, a relatively new
procedure, may be effective in reducing pain while improving movement.
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