3-(1) リウマチ手の機能再建(シンポジウム関節リウマチの診療 : 最近の進歩)(第584回新潟医学会)

概要

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The aim of surgical treatment of the rheumatoid hand and wrist is to improve function by relieving pain and restoring balance of the hand, not merely to enhance appearance by cosmetically correcting deformity. It should be understood that surgery does not fully restore normal function to the hand, as the progressive nature of the disease means that the bone and soft tissue around the affected joint have undergone deterioration by the time of surgery. Surgery is recommended for the patients who have lost or are likely to lose functions to perform various manual tasks independently, due to persistent pain, deformity, instability and loss of mobility in the affected joint exceeding 6 months. However, in patients with tendon ruptures or carpal tunnel syndrome, surgery should be considered as early as possible, before irreversible muscle and nerve changes occur. Before surgical procedures are planned, comprehensive conservative management should be performed systematically with cooperation among the rheumatologist, the surgeon and the thrapist. When the patient is highly motivated, and the expected surgical benefits surpass the advantages of a substitution pattern and the effectiveness of joint protective devices, the surgical treatment of the hand and wrist brings long-lasting symptomatic relief and functional improvement.
新潟大学の論文
2003-09-10