Abstract
Long term follow-up results of wrist synovectomy with Clayton's tendon transfer were evaluated clinically and radiologically. Twelve wrists of 10 patients with classical rheumatoid arthritis (all women) were operated on. The average age at operation was 54 years, and the average follow-up period was 7.6 years, with a range from 5 to 11.5. Two wrists were Stage II; 9, Stage III; and 1, Stage N.
All patients obtained almost complete relief of pain after surgery. The pain in 8 wrists disappear-ed completely. The preoperative average arc of dorsal-palmar flexion was 59°; postoperatively it was 39°. The rotation of the forearm has been well maintained. The radial rotation of the wrist, as measured by Shapiro's method, was significantly reduced after surgery (p < 0.01) . Clayton's mea-surement showed that the ulnar drift of fingers was kept at less than 15°in 7 wrists. Only two wrists progressed to the severe stage of over 30 degrees. Therefore, the wrist synovectomy is consid-ered to be beneficial in relieving pain and preventing the progression of ulnar drift. However, little im provement of wrist motion can be expected with this operation.
