DOES WRIST FUSION CAUSE DESTRUCTION OF THE FIRST CARPOMETACARPAL JOINT IN RHEUMATOID-ARTHRITIS - 18 PATIENTS FOLLOWED FOR 2-6 YEARS

We evaluated radiographic destruction of the first carpometacarpal joi nt (CMC I) in 18 hands with wrist fusions and compared it with the uno perated contralateral hands preoperatively and after a follow-up of a mean of 4.4 (2-6) years. Patients were obtained from a prospective 20- year follow-up study of 103 patients with seropositive rheumatoid arth ritis. The degree of destruction in the CMC I-joints was evaluated wit h Larsen grades. The mean value of Larsen indices for CMC I was 0.9 be fore wrist fusion and 2.5 (p < 0.001) at the follow-up, compared to 0. 8 and 1.3 (p = 0.06) in the control hands, respectively. No preoperati ve difference was found between the hands to be fused and the control hands, but the difference was significant (p = 0.009) after the follow -up.