Surgical reconstruction of the rheumatoid hand

ABSTRACT

PATHOPHYSIOLOGY The pathophysiology involved in rheumatoid arthritis of the hand will be discussed, focusing on the anatomical derangements of the joints that result from the disease process. The consequences of these deformities on overall had function will be addressed. SURGERY The pioneering work in implant arthroplasty of the rheumatoid hand was done by Alfred B. Swanston, M.D., of Grand Rapids, Michigan in the 1960s. The paper will focus on the indications for surgery as well as the currently accepted surgical techniques utilized in surgical reconstruction of the rheumatoid hand and wrist. REHABILITATION After reconstruction hand surgery, a properly supervised rehabilitation programme is essential to guarantee a satisfactory outcome in the restoration of hand function. ECONOMICS OF RECONSTRUCTIVE HAND SURGERY In the current era of cost effective health care delivery, this type of surgery does not have to be performed in a major hospital setting. With effective regional anaesthesia and proper instrumentation, the surgery can be successfully performed in a free standing speciality clinic(AU)