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DOI: 10.1055/a-2018-3653
Korrektur von Fingerdeformitäten
Correction of Finger Deformities
Zusammenfassung
Deformitäten der Langfinger sind neben „Rheumaknoten“ die auffälligsten Veränderungen einer bestehenden Rheumatoiden Arthritis. Die Therapie beinhaltet neben der medikamentösen Einstellung der Patienten konservative Maßnahmen, in deren Mittelpunkt die Ergotherapie steht. Neben konservativen und interventionellen Versorgungen sollte die Synovialektomie zu einem frühen Zeitpunkt erwogen werden, um die Gelenke langfristig zu schützen. Bei fortgeschrittenen Deformitäten müssen periartikuläre Strukturen in der Operation adressiert werden, um Funktionsdefizite so gering wie möglich zu halten. Gleichzeitig ist auf Grund der Dynamik der Grunderkrankung immer mit einer Progredienz und erneuten Operationen zu rechnen. Eine einzelne für ein Gelenk spezifische operative Maßnahme existiert nicht, vielmehr gilt es die verschiedenen Möglichkeiten und erforderliche Alternativen in der Planung zu berücksichtigen, um diese in der Operation entsprechend dem Ziel durchführen zu können.
Abstract
Along with rheumatoid nodules, deformities of the long fingers are the most striking changes of rheumatoid arthritis. Treatment includes medication as well as conservative measures with a focus on occupational therapy. In addition to conservative and interventional care, synovectomy should be considered early to protect the joints in the long run. In advanced deformities, periarticular structures must be addressed in surgery to minimize functional deficits. Due to the dynamics of the underlying disease, progression and reoperations must always be expected. A single surgical procedure specific to a joint does not exist. Rather, the various possibilities and necessary alternatives must be taken into account in the planning so that they can be carry them out in the surgical procedure in accordance with the objective.
Publication History
Article published online:
15 March 2023
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