Osteoarthritis (OA) of the hand is a slowly progressive articular disorder. It occurs late in life and principally affects load transmitting joints.
The symptoms include pain, stiffness, difficulty in moving of and swelling in joints and in late cases deformities.
Most patients can be managed non-operatively with non-steroidal anti-inflammatory drugs, patient education and reassurance, hand therapy, splintage, activity modification and occasionally steroid injections.
Joint Reconstructive Surgery is indicated for persistent pain unresponsive to non-operative treatment or for deformity, instability or stiffness that impairs function.
There are many other types of inflammatory arthritis and these include rheumatoid arthritis, gouty arthritis, psoriatic arthritis and a few rarer forms of arthritis. In severe cases joint reconstruction is possible.
Figure A: Pre-operative deviation of the fingers due to joint destruction
Figure B: 4 artificial joints transfer and radiological picture of the joint transfer
Joints can be reconstructed by various means. These include fusion and various forms of arthroplasties. These include Excision arthroplasties Soft tissue interposition arthroplasties Vascularised joint transfers
Figure C: Joint reconstruction: Figure showing an artificial joint transfer to the left middle finger
Aftercare: Prevention of Complications