Results of tendon transfers for stabilization of wrist joints for patients with rheumatoid arthritis

Aim – to compare the results of soft tissue stabilization operations for transposition of the tendons of the long radial and ulnar extensors of the wrist and arthrodesis of the wrist joint in patients with rheumatoid arthritis. Material and methods. The study included 69 patients. Twenty-four patients (the main group) underwent transposition of the long radial and ulnar extensors of the wrist (ECU+ECRL transposition) with their subsequent tenodesis. Forty-five patients (the control group) underwent arthrodesis of the wrist joint. The DASH questionnaire was used to assess the functional status before and after surgery. The EQ-5D index was used to assess the quality of life, visual assessment scale (VAS) was used to assess pain, and disease activity was assessed using the DAS28 index. The average follow-up period for patients after surgery was 6 months. Results. The functional status of patients after surgery, assessed by the DASH scale, was significantly better in the main group of patients (39.41±10.17) compared to the control group (46.4±15.8), p0.05. Both groups showed positive dynamics of pain according to the VAS, as well as an improvement in the quality of life. In the group of patients with ECU+ECRL transposition, carried out at stages II-III of Larsen's wrist damage, the functional status of the hand according to DASH after surgery was significantly better compared to patients who underwent tendon transposition at stages IV-V of wrist damage, their median being 38 and 48 points, respectively. Conclusions. ECU+ECRL tendon transpositions are an effective method for stabilizing the wrist joints and correcting hand deformities, but they have a number of limitations, the most important of which is the degree of damage to the wrist joints and the severity of the deformities. The effectiveness of soft tissue techniques is significantly reduced when performing surgical interventions at stages IV and V of hand damage according to Larsen.