Abstract
Twenty-one wrists in 15 patients with rheumatoid arthritis who had received dorsal wrist synovectomy with resection of the distal ulna were followed up for 5 to 18 years, with an average of 7.1 years.
Only three wrists (14%) showed mild pain and had a slight recurrence of synovitis. The other 18 had excellent and durable pain relief.
Progress of bony change took place more slowly in the operated-on wrist joint than in the opposite side until 4 or 5 years post operatively. However, at the time of follow-up, X-ray that both wrist joints had similar destructive bony changes and examination showed 12 wrist joints (67%) had become ankylosis. However, in such cases rotational movement of the forearm remained with the functional range as an effect of the resectioning of the distal ulnar end, and the patients seldom had disability in the use of their wrist joint in daily living.
We concluded that although synovectomy of the wrist joint cannot prevent joint destruction, this procedure is effective for pain relief of the wrist joint in patients with rheumatoid arthritis.
