Surgical Treatment of Wrist Joint Dysfunction in Rheumatoid Arthritis: A Report of Two Cases

In rheumatoid arthritis (RA), it is important to actively treat wrist dysfunction to improve patient outcomes. Herein, we report two cases of wrist dysfunction in RA patients who required partial wrist fusion soon after drug initiation. [Case 1] A 38-year-old woman was referred to our hospital because of left wrist joint pain. At the time of examination, swelling and tenderness of the left wrist joint were observed. After 6 months of medication, no improvement in symptoms was noted; therefore, partial wrist fusion was performed. [Case 2] A 38-year-old woman was referred to our hospital because of right wrist joint pain. A plain X-ray image showed fusion of the carpal bones. Due to previous failure of drug treatment, the patient opted for arthrodesis. The postoperative course was good in both cases, and the pain improved. In these cases of monoarthritic RA, synovitis and bone destruction were observed, but blood tests showed no features of active disease, and drug treatment was ineffective. In such cases, early surgical treatment should be considered, rather than continuing conservative treatment, to ensure the best outcomes.

Ligaments Reconstruction for Posttraumatic Ulnar Translocation of the Carpus: A Case Report

Background Posttraumatic ulnar translocation of the carpus, a result of radiocarpal ligament tear is a relatively rare condition that may lead to persistent wrist pain and loss of function. Case Description We report a case of radiocarpal ligament tear of which we reconstruct it with a vascularized interosseous membrane with 13 years of follow-up. Literature Review Many treatment options have been proposed for the posttraumatic ulnar translocation, ranging from open repair to partial wrist fusion. However, the long term results have been disappointing. Clinical Relevance Though this technique of reconstruction is technically demanding, it shows promising long term clinical outcome.

A Case of Implant Failure in Partial Wrist Fusion Applying Magnesium-Based Headless Bone Screws

This article presents a case of implant failure resulting in mechanical instability of a scaphotrapezotrapezoideal arthrodesis using magnesium-based headless bone screws. During revision surgery osteolysis surrounding the screws was observed as well as degraded screw threads already in existence at 6 weeks after implantation. The supposed osseous integration attributed to magnesium-based screws could not be reproduced in this particular case. Thus, it can be reasoned that the use of magnesium-based screws for partial wrist arthrodesis cannot be encouraged, at least not in dual use.