Surgical principles and planning for the rheumatoid hand and wrist

The large volume of literature dealing with surgery for the rheumatoid hand and wrist is replete with many surgical techniques available to the surgeon caring for these patients. It is imperative to determine the effect of these many procedures on the rheumatoid patient's quality of life. Because of the inexorable progress of the disease, some of the recommended procedures have not stood the test of time, and longer followups have significantly diminished the initial enthusiasm for the procedure. A review of the principles and techniques of surgery for the rheumatoid hand and wrist is presented. Emphasis is placed on which procedures work and which do not.