Assuntos
Evolução Biológica , Dieta , Dinâmica Populacional , Antropologia Física , Fósseis , Geografia , Humanos , Movimento , SudãoRESUMO
Short-term effect of hand surgery on hand function in activities of daily life (dexterity) and pain were studied in 70 patients with rheumatoid arthritis. Only surgical interventions aimed at improvement of function and/or pain relief were included in the study. Patients were assessed before surgery and 6 and 12 months after surgery. Clinical change in the surgical group was observed in the number of painful and swollen joints, observed dexterity, and pain in the hand. Six months after surgery 74% of the patients showed positive clinical change in hand functioning and/or hand pain. Clinical effects remained stable between 6 and 12 months after surgical assessments. Both change in observed dexterity and pain had an independent impact on the patient's satisfaction with the results of the surgery.
Assuntos
Artrite Reumatoide/cirurgia , Mãos/cirurgia , Destreza Motora/fisiologia , Medição da Dor , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/fisiopatologia , Feminino , Seguimentos , Mãos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Resultado do TratamentoRESUMO
The Isoelastic prosthesis for the metacarpophalangeal joint was used in 68 rheumatoid joints. The average follow-up period was 3 years and 3 months. The subjective score for pain, appearance, and usefulness as well as the functional outcome was determined by means of a modified Green test. All subjective scores improved postoperatively, whereas function did not change significantly. Preoperative range of motion values were not available. The extension deficit after operation was 26 degrees, the average flexion 63 degrees, and the total range of motion 37 degrees. Grip strength improved only slightly. Complications included four cases of delayed wound healing and four metacarpal fractures after operation. The Isoelastic prosthesis gives satisfactory results in rheumatoid arthritis patients. The intraoperative insertion is easy and the material is well tolerated. In vivo, the implant itself is rigid enough to resist ulnar drift, although osteolysis around the plastic surface has caused recurrence of ulnar deformity.
