日本関節病学会誌
Online ISSN : 1884-9067
Print ISSN : 1883-2873
ISSN-L : 1883-2873
第38回学会寄稿
RA高度手指変形に対する手術的治療
中川 夏子香山 幸造寺島 康浩松田 茂横山 公信立石 耕司
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2011 年 30 巻 2 号 p. 109-115

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Introduction: Rheumatoid arthritis (RA) frequently affects the finger joints. Persistent synovitis of finger joints is believed to cause not only bone destruction but also various severe deformities of the hands. We report five cases of surgical intervention for finger deformities in RA patients.
Patients and Methods: Case 1 involved a 51-year-old woman who presented with severe finger deformities (thumb deformity, 2345MP ulnar deviation, and volar dislocation). She had undergone multiple surgeries of the fingers: 12345MP arthroplasties. Case 2 involved a 70-year-old woman who presented with severe finger deformities (thumb deformity, 2345MP flexion contracture, and volar dislocation). She had undergone multiple surgeries of the fingers: wrist synovectomy, 1CM joint arthroplasty without implant, 1MP joint arthrodesis, 2345MP arthroplasty with implants, and tendon transfer. Case 3 involved a 59-year-old woman who presented with severe finger deformities (thumb deformity, 2345MP swan-neck deformity, volar dislocation, and ulnar deviation). She had undergone multiple surgeries of the fingers: wrist synovectomy, 1MP joint arthroplasty without implant, 1IP joint arthrodesis, 2345MP arthroplasty with implants, and lateral band mobilization of 345PIP joints. Case 4 involved a 65-year-old woman who presented with severe finger deformities (thumb button-hole deformity, 345MP dislocation/ulnar deviation). She had undergone multiple surgeries of the fingers: wrist synovectomy, 1MP joint arthroplasty without implant, 345MP arthroplasty with implants, and 5PIP arthrodesis. Case 5 involved a 44-year-old woman who presented with swelling and severe instability of the left wrist. She had undergone total wrist fusion with β-tricalcium phosphate.
Results: The patients were satisfied with the functional and cosmetic improvement after the surgery.
Conclusion: We recommend surgical intervention for finger deformities in RA patients.
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© 2011 日本関節病学会
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