Wanivenhaus A
Universitätsklinik für Orthopädie, Medizinische Universität Wien.
Orthopade. 2005 Jan;34(1):29-35. doi: 10.1007/s00132-004-0744-y.
The affection to the flexor tendons of the patient with rheumatoid arthritis represents a substantial rheumatic change in the hand, which is characterized by restriction of movement, ulnar deviation in the level of the metacarpophalangeal joint and palmar incomplete dislocation. Early treatment by removing any possible constriction areas in synovial proliferations in the area of the flexor pullies or a complete tendosynovectomy makes an extensive restitution possible. In the case of only one ruptured flexor tendon, it can be treated by the transfer of the neighboring superficialis tendon or a tendon transplant. If there are multiple ruptures, the results will be clearly worse in regard to movement and strength, whereby as a rule the result is seriously influenced by articular destruction. Therefore, an early tendosynovectomy and a preventive operation to the wrist have to be recommended.
类风湿性关节炎患者的屈肌腱受累是手部显著的风湿性改变，其特征为活动受限、掌指关节水平尺偏及掌侧不完全脱位。早期通过消除屈肌滑车区域滑膜增生中任何可能的狭窄区域或进行彻底的腱鞘滑膜切除术，有可能实现广泛的恢复。若仅有一条屈肌腱断裂，可通过转移相邻的浅肌腱或进行肌腱移植来治疗。若有多条肌腱断裂，在活动和力量方面结果会明显更差，通常结果会受到关节破坏的严重影响。因此，必须推荐早期腱鞘滑膜切除术及对腕关节进行预防性手术。
