FLEXOR TENOSYNOVECTOMY AND TENOLYS IS IN LONGSTANDING RHEUMATOID ARTHRIT IS A long-term review of 49 hands

A total of 43 patients (49 hands; 424 flexor tendons), who had rheumatoid arthritis of more than 15 years duration at the time of surgery, were clinically assessed at a mean follow-up of 5.7 years (range, 1.2-12 years). Pain and inability to flex actively despite a good passive range of motion were the main surgical indications. The results suggest hat the patients had excellent sustained pain relief (mean score=0.9) and were highly satisfied with the outcome of the procedure (mean score = 2.2). 81 % had adequate pulp-to-pulp and key pinch. Range of finger motion (total active motion, TAM) was excellent to good in 45 % and fair in 22%. Thirty-three per cent were graded as poor and these were found to be multifactorial in origin, with associated significant joint disease, preoperative tendon ruptures, extensive digital surgery, readhesions and combinations of operative procedures which adversely affect the rehabilitation programme. Flexor tenosynovectomy with tenolysis is a useful procedure with a low rate of recurrence. Journal of Hancl Surgery (British and European Volume, 1996) 21B:4:538-543 The incidence of flexor tendon involvement in rheuma-toid disease has been found to vary between 42% (Kellgren and Ball, 1950) and 55 % (Gray and Gottlieb