Rekonstrukce zápěstí u pacientů s revmatoidní artritidou

Reconstruction of the wrist in patients with rheumatoid arthritis

Characteristic symptoms of the wrist joint affected by rheumatoid arthritis include pain, stiffness, instability and loss of grip strength. The aim of both complete and partial arthrodesis is to achieve painless and fixed wrist in a proper axial position. Clinical and radiological aspects as well as requirements and age of the patients, activity of the disease, type of destruction and its potential progression are necessary to consider when wrist joint reconstruction is indicated. Surgical intervention solves the problem of all the joints in the wrist such as radiocarpal joint, the intercarpal-carpometacarpal joint, as well as distal radioulnar joint. The joint stabilization is achieved only by using the bone fusion. To maintain the maximal available range of motion the least possible surgical procedure is recommended. Patient must be informed about all the possibilities and consequences of each type of operation. In accordance with reduced progression of deformity, operations stabilizing the wrist joint are considered as preventive performances.

Key words:
partial wrist arthrodesis, complete wrist arthrodesis, rheumatoid arthritis