Hand Joint Replacements in Traumatic and Arthritic cases
Author(s): Lucia Heras-Garcia
Rheumatoid disease affects almost all of the musculoskeletal system. In the case of the upper extremity we should be aware of the extension and degree of tissue involvement, the intensity of the synovitis affecting the joints, the deformity, the associated tendon dislocation or ruptures and we should assess the range of active and passive joint mobility. All those parameters influence in choosing the type of joint replacement we should use and the necessity in dealing with the soft tissue involvement associated with this disease. On the other hand the post-traumatic arthritis arising after a trauma which involved a joint, behave in a different way, most of the time we only have to deal with one single joint, soft tissue is minimally involved and tends to produce rigidity more than instability, the problem is not progressive and that is why the type of joint replacements developed to deal with this situation is completely different. The implants for small joint arthroplasty have evolved from more than 50 years since the research of Swanson, improving even the sylastic implants, with less complications and better and more natural range of motion. We will discuss the more recent implants, surgical techniques and results.