[Dorsal tenosynovectomy of the wrist in rheumatoid arthritis. Results obtained in 30 cases]

With reference to a series of thirty synovectomies of the wrist in patients with rheumatoid arthritis, the authors report the results observed after an average interval of three years and six months. There was a remarkable reduction in pain in three-quarters of the cases. On the other hand, loss of mobility was noted in 15 patients. Resection of the cubital head was carried out in half of the cases. This was followed in two cases by internal translocation of the carpus, and in three cases by internal translocation combined with cubital inclination of the hand. The results of the tenddon repairs carried out in six patients have been completely satisfactory. A study of the present cases and of data from the literature confirms the local prophylactic value of tenosynovectomy which may also prevent tendon ruptures. The best result are seen in the less evolutive forms in which the risk of relapse is least, and in cases in which surgery is carried out on stable wrists with cartilage showing little alteration. In the presence of inferior radiocubital arthritis the resection must be systematic as it makes it possible to carry out a complete synovectomy of this joint. The authors compare the value of surgical synovectomy of the wrist with that of radioactive synoviorthesis.