Rheumatoid arthritis of the wrist.

Rheumatoid deformity alone is not an indication for surgery; pain and loss of function are. For the wrist, the selection of the procedure depends on thorough clinical and radiographic evaluations for tendon and joint synovitis, tendon ruptures, nerve compressions, and deformity. Operative treatment varies with the patient's age, handedness, occupation, needs, and expectations. One or more of the following modalities may need to be used: joint and tendon synovectomy, tendon transfer, repair and relocation, ligament repair, ligamentodesis and capsulodesis, limited and total arthrodesis, arthroplasty with and without arthrodesis, and with and without endoprosthesis, and different techniques for the management of the painful distal radioulnar joint.