Rheumatoid Hand Literature review - Kate Owers 20/1/2005

- no RCTs

- no meta-analyses

- 2 good review articles in Current Orthopaedics

The Principles of Surgery in the Rheumatoid Hand

P. Burge Current Orth 2003 17 p17-27

The Rheumatoid Thumb

C. Milroy and H. Belcher Current Orth 2001 15 p338-345

- Retrospective case series for 'long-term' follow-up of recognised procedures

Surgical Correction of Extensor Tendon Subluxation and Ulnar Drift in the Rheumatoid Hand

P. Dell J Hand Surg. 2001 26B: 560-564

- 15 pts, 72 procedures in 18 hands, f/up 9 years

- passively correctable, no joint damage on Xray

- Intinsic release + strip of EDC to reef MCPJ radially

- Drift corrected from 47 ° >> 8 °

- Arc of movement 38 ° >> 56 ° and less lag

- No recurrence

Swanson Metacarpophalangeal Joint Arthroplasty in Patients with Rheumatoid Arthritis

K. Hansraj Clin. Orth 1997 342 p11-15

- 58 pts, 170 implants, f/up 5 yrs

- 11/12 fractured implants revised

- 54% pain free, slight pain 39%

- 100% feed themselves, 94% can do buttons

- Arc of motion reduced 38 ° >> 27 °

- Survivorship analysis 90% at 10 years (? Nos)

Swanson Proximal Interphalangeal Joint Arthroplasty in Patients with Rheumatoid Arthritis

C. Ashworth Clin Orth 1997 342 p34-37

- 45 pts, 99 implants, f/up 5.8 yrs

- 10 fractures revised

- 67% pain free, slight pain 28%

- 100% feed themselves, 96% can do buttons

- Arc of motion reduced 38 ° >> 29 °

- Survivorship analysis 81% at 9 years



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