Combined wrist arthrodesis and metacarpophalangeal joint arthroplasty in rheumatoid arthritis.

This paper describes a surgical procedure which combines wrist arthrodesis and metacarpophalangeal joint arthroplasty into one operation. Its basic indication is the severely crippled rheumatoid patient who is faced with multiple reconstructive surgical procedures. In addition to the combined wrist fusion and metacarpophalangeal joint arthroplasty, other surgical procedures can sometimes be performed into same hand, thereby completing the entire reconstruction in one operation. Of the 19 patients who have undergone the combined procedure, only one failed to obtain a solid clinical arthrodesis. There were no infections, skin sluffs or other complications. Combining the two procedures did not jeopardize either wrist fusion or metacarpophalangeal joint arthroplasty. Specific contraindications for the procedure are fixed wrist flexion contracture or a complete dislocation requiring extensive exposure in order to align or reduce the radiocarpal joint.