関節リウマチによる手指変形に対する軟部組織再建

抄録

 The finger joints are commonly affected sites in patients with rheumatoid arthritis. The aesthetic appearance due to finger deformity may affects the psychological aspect of the patient. Implant arthroplasty is indicated for severely damaged finger joints, whereas soft tissue reconstruction procedures are applied to passively correctable deformities with mild joint destruction. One of the features of finger deformity in rheumatoid arthritis is that soft tissues such as the collateral ligaments, volar plate, flexor tendons, and extensor tendons are damaged by aggressive synovitis, which causes soft tissue imbalance. It is necessary to fully understand the anatomical structure of the finger joints and to reconstruct the soft tissue balances for the treatment of their deformities. After the emergence of biologic agents, the number of cases with severe joint destruction has decreased, and cases in which joint preservation procedures are possible is increasing. However, it is difficult to treat only with soft tissue reconstruction in cases with contractures. Further improvement of treatment including early intervention is imperative.