Open Synovectomy for Chronic Infectious Arthritis of the Wrist

Lee,  Sanglim; Sohn,  Sueen; Jeon,  Suk Ha; Shin,  Yong Woon

doi:2012.17.4.166

Arch Hand Microsurg > Volume 17(4); 2012 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2012;17(4):166-172.
Published online December 30, 2012.
DOI: https://doi.org/10.12790/jkssh.2012.17.4.166

Open Synovectomy for Chronic Infectious Arthritis of the Wrist

Sanglim Lee, Sueen Sohn, Suk Ha Jeon, Yong Woon Shin

¹Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. woonysos@hanmail.net
²Department of Orthopedic Surgery, National Medical Center, Seoul, Korea.

Received: 2 September 2012 • Revised: 14 October 2012 • Accepted: 24 October 2012

Abstract

Purpose
We reported the results of open synovectomy for chronic infectious arthritis of the wrist.

Methods
Fifteen patients who had chronic infectious arthritis of the wrist and underwent open synovectomy were reviewed retrospectively baesd on preoperative periods, symptoms, results of laboratory tests, radiological findings including magnetic resonance imaging (MRI), hospitalization period, and others. Pain scale and subjective satisfaction were checked by phone interview.

Results
Average preoperative period was 96.1 days. Pain on motion and edema were observed in all cases. Four patients had positive bacterial cultures and three were identified as tuberculous infection. Signal changes of bones were observed in MRI of 10 patients. Osteomyelitis was found in 8 patients during the operation and bone resection or fusion should be performed in three. Average number of operation times was 1.53.

Conclusion
When the patients show chronic swelling and pain on motion of the wrist, diagnostic work-ups for chronic infectious arthritis should be performed including arthrocentesis and MRI. Treatment including open synovectomy should be done immediately.