Clayton M L, Ferlic D C
Clin Orthop Relat Res. 1975 Jan-Feb(106):192-7. doi: 10.1097/00003086-197501000-00030.
The wrist is the key joint of the upper extremity and is frequently seriously involved in rheumatoid arthritis. Surgery is often indicated to control the effects of the synovitis which often includes rupture of both flexor and extensor tendons. Early synovectomy is indicated. Tenosynovectomy, synovectomy, distal ulnar resection and transposition of the dorsal carpal ligament beneath the extensor tendons, has been effective in preventing rupture of the extensor tendons. The wrist also has an effect on ulnar drift of the fingers. Transfer of the extensor carpi radialis longus to the extensor carpi ulnaris is recommended in patients who do not have the ability to actively ulnar deviate the wrist. Wrist fusion has proven to be effective in patients with marked destruction, deformity or pain, or where there has been a rupture of both radial wrist extensors.
腕关节是上肢的关键关节，在类风湿性关节炎中常受到严重影响。通常需要进行手术来控制滑膜炎的影响，滑膜炎常常包括屈肌腱和伸肌腱的断裂。早期滑膜切除术是必要的。腱鞘滑膜切除术、滑膜切除术、尺骨远端切除术以及将腕背侧韧带转位至伸肌腱下方，已被证明在预防伸肌腱断裂方面是有效的。腕关节对手指的尺偏也有影响。对于无法主动使腕关节尺偏的患者，建议将桡侧腕长伸肌转移至尺侧腕伸肌。腕关节融合术已被证明对有明显破坏、畸形或疼痛的患者，或桡侧腕伸肌均断裂的患者有效。
