Present approach to the severely involved rheumatoid wrist.

The wrist is a common target for rheumatoid arthritis, with the radiocarpal joint being involved more often than the midcarpal joint. The authors discuss the treatment modalities available for patients with advanced disease: total wrist fusion, flexible implant arthroplasty, and partial wrist fusion. The last procedure, utilized only since 1982 and limited to patients with only radiocarpal joint involvement, eliminates pain and corrects deformity while maintaining a significant range of motion. The indications and techniques for each procedure are described.