ABSTRACT
If wrist involvement reveals the rheumatoid disease in only 2.7% of patients, 35% of rheumatoid patients will suffer from problems with their wrists in the early stages. During their life, almost all patients will suffer from wrist problems, with bilateral involvement in 95% of cases. In two-thirds of the patients, wrist involvement will leave them with definitive sequelae (Clayton and Ferlic 1965, Eiken et al 1975, Allieu and Brahin 1977, Rasker et al 1980, Tubiana et al 1980, Brown 1984, Vahvanen and Patiala 1984, Wilson 1986, Flatt 1995). Surgery of the wrist represents between 20 and 40% of all operations performed on rheumatoid patients, as a stable, painless and well-aligned wrist is mandatory for the strength and function of the hand (Straub and Ranawat 1969, Linscheid and Dobyns 1971, Eiken et al 1975, Allieu and Brahin 1977, Nalebuff and Garrod 1984, Dennis et al 1986, Vicar and Burton 1986, Wilson 1986). Clinical symptoms and deformities will vary according to the predominant localization of the pannus (Tubiana et al 1980, Mannerfelt 1984). Synovial involvement of the wrist may involve three distinct anatomical compartments that are considered a surgical unit because their anatomical proximity: the radio-carpal joint, the distal radio-ulnar joint, and the synovial sheath of the extensor tendons under the extensor retinaculum.
