腕关节骨关节炎资料

您的感受

您可能会感到手腕深处有钝痛。这通常是由磨损性关节炎引起的，即骨骼之间的缓冲软骨已经退化。疼痛通常位于手腕中央或拇指侧。在进行日常手部活动时，疼痛往往会加剧。

简单的动作可能会变得困难。您可能难以牢固地抓握物体或转动门把手。将手伸到背后扣内衣可能会感到僵硬和疼痛。塞衬衫时，您可能需要移动整个手臂，而不仅仅是手腕。即使提起轻的物品（如水壶或一袋杂货），也可能引起剧烈不适。

疼痛通常在活动后加重。经过一整天使用双手后，您可能会注意到疼痛在傍晚时搏动感更强。有些人发现将手腕放在枕头上有助于缓解酸痛。然而，僵硬也是体验中的重要部分。早晨刚醒来时，您的手腕可能会感觉特别紧绷且难以活动。这种晨僵在您开始活动后通常会稍微缓解，但如果休息过久，它可能会再次出现。

由于这种疼痛，睡眠可能会变得具有挑战性。许多患者发现，如果不将压力施加在受影响的手腕上，就无法侧卧。您可能会辗转反侧，试图找到一个不会加剧关节疼痛的姿势。这种缺乏休息的睡眠会使您在白天感到疲惫和沮丧。

移动手腕时，感到研磨感或听到咔哒声是很常见的。这是失去保护性软骨后骨骼与骨骼相互摩擦所致。虽然这可能令人担忧，但这是晚期关节炎的典型迹象。了解这些症状有助于我们制定您的护理计划。我们希望确保在讨论针对您具体情况的最佳治疗方案时，您感到被倾听和支持。

实际发生了什么

您的手腕由八块紧密排列的小骨头组成。在骨关节炎中，覆盖这些骨骼的光滑软骨会逐渐磨损。可以将软骨视为减震器或垫片。一旦失去这种保护，骨头之间就会相互摩擦。这会导致疼痛、僵硬和肿胀。

这种退行性关节炎通常始于特定部位。它可能开始于前臂与手腕的连接处，也可能始于腕骨之间。随着关节表面的退化，手腕会失去其天然的滑动功能。您在活动手腕时可能会感到摩擦感或卡顿感。简单的日常任务，如转动门把手，也会变得困难。

您的外科医生解释说，这种损伤会改变手腕的运动方式。例如，四角融合术会改变某些骨头的位置。这种位置变化可能会增加剩余关节的压力。随着时间的推移，这种额外的压力可能会导致这些区域进一步磨损。

我们清楚，没有任何手术能将您的手腕恢复到最初完美的状态。每种选择都涉及权衡利弊。融合手术通过限制活动来减轻疼痛。关节置换旨在保留活动能力，但伴随更高的风险。您的外科医生将讨论哪种方案适合您的日常需求和活动水平。

目标是消除疼痛并为您提供一个稳定的手腕。您可能会损失部分活动范围，但会获得稳定性。许多患者认为，为了缓解疼痛，这种权衡是值得的。我们专注于帮助您以更少的不适回归日常生活。

我们能做什么

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 博士在我们的诊所通过关注您的具体需求来处理这一问题。患者由全科医生或物理治疗师转诊至我们的诊所。诊所评估（病史、体格检查以及必要的影像学检查）确立诊断。对于退行性或长期存在的问题，我们通常先尝试非手术治疗——包括活动调整、物理治疗或手部治疗、夹板固定和注射治疗——并在这些方法未能带来足够改善时考虑手术。对于结构性或急性问题，可能会直接建议手术，而无需先进行非手术治疗试验。

您可以从改变手部使用方式开始。我们建议避免提重物或引起疼痛的重复性抓握动作。物理治疗师可以教您一些练习，以保持腕关节的活动度并增强周围肌肉的力量。夹板可以在日常活动中为关节提供支持。我们通常建议给这种方法几周的时间来发挥作用。如果疼痛持续存在，我们可能会建议用药。非处方止痛药或抗炎药可以帮助缓解不适。在某些情况下，我们会提供关节内注射。皮质类固醇注射可在有限时间内减轻肿胀和疼痛。透明质酸或富血小板血浆（PRP）注射旨在为关节提供缓冲，但效果因人而异。这些治疗不能逆转关节炎，但可以改善您的舒适度和功能。

当保守治疗未能带来足够改善时，会考虑手术。手术的目标是缓解疼痛并恢复稳定性。选项包括融合术（将骨骼连接在一起以停止疼痛的运动）或置换术（用人工部件替换受损表面）。我们根据受累的具体关节、您的需求以及并发症的风险来选择最佳方案。在大多数情况下，腕关节骨关节炎没有单一的首选方案。我们会与您讨论这些选择，以达成共同决策。

预期情况

治疗后，您的手腕可能会在数周或数月内感到僵硬和疼痛。缓解疼痛是最常见的治疗目标，大多数人在适当护理下会发现症状显著改善。如果不进行治疗，磨损性关节炎通常会持续存在或随时间缓慢加重。您的症状可能会时好时坏，但潜在的关节损伤往往呈进展性。

如果您选择腕关节融合术，可以预期获得可靠的疼痛缓解。该手术是治疗严重关节炎最常见的挽救性方案。它能稳定关节并减少残疾。然而，它会限制您在各个方向上的手腕活动度。您将无法完全恢复手腕的全部功能。您的握力通常会改善，但活动范围会减小。

如果您选择关节置换术，目标是获得更大的活动度。与融合术相比，该选项的并发症风险更高。您可能会面临松动或需要进一步手术等问题。如果置换失败，转换为融合术是一种安全有效的备用方案。这种挽救性手术能可靠地改善功能并提供显著的疼痛缓解。相反，如果融合术失败，转换为现代关节置换术也是可行的。

恢复期涉及一段活动受限的时期。尽早开始轻柔的活动有助于您更快恢复功能性活动。如果您尽早开始，所需的康复治疗次数会减少。大多数人能以减轻的疼痛回归日常活动，但仍会存在一些限制。约20%的患者对结果不满意，而86%的患者能恢复完全的工作职责。您的医生将帮助您权衡活动度与稳定性之间的利弊。决策取决于您的活动水平以及接受潜在翻修风险的意愿。

何时就医

如果您的腕部持续性疼痛经休息后无改善，请咨询您的全科医生。如果您注意到出现无力、不稳或卡顿、脱位感，请要求专科医生评估。这些症状可能会干扰您的睡眠或工作。若病情突然加重，请及时寻求医疗帮助。您的外科医生将评估您是否存在磨损性关节炎。他们将讨论腕关节融合术或关节置换术是否适合您。请注意，这两种方案均存在风险。腕关节融合术可提供可靠的疼痛缓解，但会限制活动度。关节置换术可保留活动度，但并发症发生率较高。您的外科医生将根据您的具体需求，指导您做出选择。

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Osteoarthritis of the hand and wrist requires an individualized approach to treatment strategies based on site-specific diagnoses and varying disease manifestations [1].
While functional improvement was observed for arthroplasty patients, robust long-term follow-up data on wrist arthroplasty are not yet available [3].
Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery in patients with rheumatoid arthritis [9].
While outcomes are generally favorable for therapeutic surgeries like arthrodesis and arthroplasty, further study is required to determine the best indications for ulnar head arthroplasty [36].
Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given the proper patient selection and indications [19].
Minimal arthroplasty may provide a temporary solution for active patients with symptomatic early wrist arthritis who are not candidates for salvage wrist surgery [26].
The technique of closing wedge radial osteotomy could prove a reliable first line treatment for patients with debilitating wrist osteoarthritis confined to scaphoid/scapholunate articulation with radius as it preserves the ligamentous insertions and the bone stock [4].
Distal scaphoid excision should be preferred to improve functional results while decreasing scaphotrapeziotrapezoidal osteoarthritis and radiocarpal nonunion rates in radioscapholunate fusion for radiocarpal osteoarthritis [17].
The authors prefer proximal row carpectomy for SLAC wrists with preserved capitate head cartilage due to socio-economic benefits, lower complication rates, and procedural ease [46].
Wrist denervation was a viable salvage option for patients with symptomatic SLAC wrist osteoarthritis to preserve motion, decrease pain, and increase function with a low absolute failure rate at mid- to long-term follow-up [12].
Removal of the trapezium as treatment for basal thumb osteoarthritis does not increase the risk of developing wrist osteoarthritis in the long term [5].

Anatomy & Pathophysiology

Type I and III wrists in early rheumatoid arthritis exhibit radiographic progression and ultimately undergo deformation [8].
Combining traditional qualitative evaluation and quantitative measurements may improve the classification of wrist osteoarthritis [11].
The Watson and Ballet classification of scapholunate advanced collapse (SLAC) wrist osteoarthritis is widely accepted, simple, and a well-recognized guide to treatment despite significant limitations [20].
Radiographic classification of SLAC wrist has moderate reliability and reproducibility [27].
Classification of scaphoid nonunion advanced collapse (SNAC) wrist has limited reliability [27].
Staging systems for SNAC wrist lack agreement [28].
SNAC wrists differ from SLAC wrists in exhibiting a decreased sagittal lunotriquetral angle, indicating a distinct pathomechanism of carpal instability [34].
In the early stages of hand osteoarthritis, there is a functional deficit associated with reduced muscle activity of the wrist muscles during manual activities [40].

Classification

Advanced osteoarthritis of the midcarpal joint without radiocarpal involvement may be more common than previously thought [7].
Isolated osteoarthritis of the scaphotrapeziotrapezoidal joint is the most prevalent pattern of wrist osteoarthritis [7].
Reviewing multiview radiographs more commonly yielded Vender stage 3 osteoarthritis classification for SNAC wrist [30].
The Simmen classification of wrist destruction in rheumatoid arthritis is useful in early disease in about 50% of cases [44].
The Simmen classification provides reasonably reliable identification of wrists at significant risk of becoming severely unstable, though the false-negative rate is substantial [44].

Clinical Presentation

Hand manifestations of osteoarthritis can be debilitating, with initial treatment being medical and many patients doing well with splinting and hand therapy [2].
Subtle differences in history, examination, laboratory values, and imaging, rather than one pathognomonic finding, can improve the diagnostic acumen and expedite appropriate treatment options for monoarticular arthritis of the hand and wrist [6].
The occurrence of osteoarthritis of the scaphotrapeziotrapezoid and distal radioulnar joints is affected by the presence of osteoarthritis of the adjacent joint [16].
Patients with wrist arthritis who undergo surgery face higher risks of carpal tunnel syndrome (CTS) and subsequent carpal tunnel release (CTR) than those managed conservatively [13].

Investigations

Initial treatment for hand manifestations of osteoarthritis is medical, with many patients doing well with splinting and hand therapy [2].
Subtle differences in history, examination, laboratory values, and imaging can improve diagnostic acumen and expedite appropriate treatment options for monoarticular arthritis of the hand and wrist [6].
Type I and III wrists had radiographic progression and ultimately underwent deformation [8].
The occurrence of osteoarthritis of the scaphotrapeziotrapezoid and distal radioulnar joints was affected by the presence of osteoarthritis of the adjacent joint [16].
Reviewing multiview radiographs more commonly yielded Vender stage 3 osteoarthritis classification for SNAC wrist arthritis [30].
With CT as the reference method, MRI showed moderate sensitivity and good specificity and accuracy for detection of erosions in rheumatoid arthritis and healthy wrist bones [49].
Radiography showed very low sensitivity for detection of bone erosions in rheumatoid arthritis and healthy wrist bones [49].
Subjective radiographic grading of the radioscaphoid joint was unable to detect mild arthritis but was able to distinguish between mild and moderate/severe arthritis [50].
Bone density was greater at the capitolunate joint, the radial styloid, and the radiolunate joint in SNAC wrists compared to controls [52].
Computed tomography is more sensitive than conventional radiography for detecting bone erosions in rheumatoid arthritis [53].

Treatment

Non-Operative Management

Neuromuscular exercise therapy and range-of-motion training show no clinically meaningful differences in the treatment of wrist osteoarthritis at 6 and 12 months [39].

Surgical Management: General Principles

Surgical intervention markedly improves hand and wrist function for many rheumatoid patients [29].
Preservation of movement is beneficial to function, and a preferable compromise may be selective excision and partial fusion of the wrist using knowledge of the aetiology and pattern of degenerative change [25].
Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given proper patient selection and indications [19].

Surgical Management: Arthrodesis and Fusion

Patients tolerate the restrictions caused by a stiff wrist provided it is painless [21].
Four-corner fusion and scaphoid excision using headless compression screws for SLAC and SNAC wrist deformities result in most patients being pleased postoperatively, with improvement in wrist pain being the most common finding [10].
Radioscapholunate fusion for radiocarpal osteoarthritis benefits from distal scaphoid excision to improve functional results while decreasing scaphotrapeziotrapezoidal osteoarthritis and radiocarpal nonunion rates [17].
Closing wedge radial osteotomy is a reliable first-line treatment for patients with debilitating wrist osteoarthritis confined to the scaphoid/scapholunate articulation with the radius, as it preserves ligamentous insertions and bone stock [4].

Surgical Management: Arthroplasty

Newer fourth-generation wrist implants appear to be performing better than earlier designs [18].
Minimal wrist arthroplasty may provide a temporary solution for active patients with symptomatic early wrist arthritis who are not candidates for salvage wrist surgery [26].

Surgical Management: Salvage and Other Procedures

Wrist denervation is a viable salvage option for patients with symptomatic SLAC wrist osteoarthritis to preserve motion, decrease pain, and increase function with a low absolute failure rate at mid- to long-term follow-up [12].
Arthroscopic synovectomy of the wrist can provide pain relief and functional improvement with control of synovitis in 75% of rheumatoid wrists that have not responded to medication [51].

Complications

Robust long-term follow-up data on wrist arthroplasty are not yet available [3].
Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery [9].
Most patients were pleased postoperatively following four-corner fusion and scaphoid excision, with improvement in wrist pain being the most common finding [10].
There is an approximate 10% risk of secondary wrist arthrodesis in patients with persistent or progressive ulnar wrist pain following partial wrist denervation [14].
Functional results of four-corner fusion for SLAC and SNAC wrist were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients [15].
Elbow, wrist, and hand surgery provided long-lasting benefits in rheumatoid arthritis patients [23].
The overall survival probability of partial wrist denervation in painful wrist osteoarthritis is above 50% at 5 years [24].
Delayed-onset ulnar neuropathy at the wrist can occur 12 to 30 years after conservatively treated distal radius fractures with malunion and distal radioulnar joint (DRUJ) arthritis [31].

Recovery

Partial wrist denervation in inflammatory arthritis carries an approximate 10% risk of secondary wrist arthrodesis in patients with persistent or progressive ulnar wrist pain [14].
Functional results of 4-corner fusion for SLAC and SNAC wrist are good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients [15].
Elbow, wrist, and hand surgery provided long-lasting benefits in rheumatoid arthritis patients according to patient-reported outcome assessments [23].
Partial wrist denervation in painful wrist osteoarthritis has an overall survival probability above 50% at 5 years [24].
Delayed-onset ulnar neuropathy at the wrist can occur 12 to 30 years after conservatively treated distal radius fractures with malunion and distal radioulnar joint arthritis [31].

Key Evidence

[L5] Osteoarthritis of the hand and wrist requires an individualized approach to treatment strategies based on site-specific diagnoses and varying disease manifestations. [1] (10.1016/j.jht.2022.01.001)
[L5] The hand manifestations of osteoarthritis can be debilitating, with initial treatment being medical and many patients doing well with splinting and hand therapy. [2] (10.1016/j.hcl.2010.09.003)
[L2] While functional improvement was observed for arthroplasty patients, robust long-term follow-up data on wrist arthroplasty are not yet available. [3] (10.1177/1753193420953683)
[L4] The technique could prove a reliable first line treatment for patients with debilitating wrist osteoarthritis confined to scaphoid/scapholunate articulation with radius as it preserves the ligamentous insertions and the bone stock. [4] (10.1016/j.jisako.2025.100448)
[L3] Removal of the trapezium as treatment for basal thumb osteoarthritis does not increase the risk of developing wrist osteoarthritis in the long term. [5] (10.1186/s13018-021-02856-x)
[L5] Subtle differences in history, examination, laboratory values, and imaging, rather than one pathognomonic finding, can improve the diagnostic acumen and expedite appropriate treatment options for monoarticular arthritis of the hand and wrist. [6] (10.1016/j.jhsa.2012.04.010)
[L4] Advanced osteoarthritis of the midcarpal joint without radiocarpal involvement may be more common than previously thought, with isolated osteoarthritis of the scaphotrapeziotrapezoidal joint being the most prevalent pattern. [7] (10.1177/17531934241275450)
[L2] Type I and III wrists had radiographic progression and ultimately underwent deformation. [8] (10.1016/j.jhsa.2009.01.016)
[L4] Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery. [9] (10.1016/j.jhsa.2024.03.002)
[L4] Most patients were pleased postoperatively, with improvement in wrist pain being the most common finding. [10] (10.1097/bth.0b013e3181f60fec)
[L4] Combining traditional qualitative evaluation and quantitative measurements may improve the classification of wrist osteoarthritis. [11] (10.1177/1753193416669261)
[L4] This method of wrist denervation was a viable salvage option for patients with symptomatic SLAC wrist osteoarthritis to preserve motion, decrease pain, and increase function with a low absolute failure rate at mid- to long-term follow-up. [12] (10.1016/j.jhsa.2021.02.023)
[L2] Patients with wrist arthritis who undergo surgery face higher risks of CTS and subsequent CTR than those managed conservatively. [13] (10.1016/j.jhsa.2026.01.013)
[L4] Our findings suggest an approximate 10% risk of secondary wrist arthrodesis in patients with persistent or progressive ulnar wrist pain. [14] (10.1007/s10067-019-04645-8)
[L4] Functional results were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients. [15] (10.1177/1558944716681949)
[L4] The occurrence of osteoarthritis of the scaphotrapeziotrapezoid and distal radioulnar joints was affected by the presence of osteoarthritis of the adjacent joint. [16] (10.1016/j.jhsa.2023.05.009)
[L4] Distal scaphoid excision should be preferred to improve functional results while decreasing scaphotrapeziotrapezoidal osteoarthritis and radiocarpal nonunion rates. [17] (10.1055/s-0039-1688939)
[L1] The newer fourth-generation wrist implants appear to be performing better than earlier designs. [18] (10.1055/s-0038-1646956)
[L3] Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given the proper patient selection and indications. [19] (10.1016/j.jhsa.2013.02.013)
[L5] Despite its significant limitations, the Watson and Ballet classification of SLAC wrist osteoarthritis is widely accepted, simple, and a well-recognized guide to treatment. [20] (10.1097/corr.0000000000000451)
[L4] Patients tolerate the restrictions caused by a stiff wrist provided it is painless. [21] (10.1054/jhsb.2002.0806)
[L4] Our original patient-reported outcome assessment tool revealed that elbow, wrist and hand surgery provided long-lasting benefits in RA patients. [23] (10.1111/1756-185x.13340)
[L3] The study found an overall survival probability above 50% at 5 years after partial wrist denervation in painful wrist OA. [24] (10.1177/17531934261425490)
[L5] Preservation of movement is beneficial to function, and a preferable compromise may be selective excision and partial fusion of the wrist using knowledge of the aetiology and pattern of degenerative change. [25] (10.1302/0301-620x.97b10.35717)
[L4] Minimal arthroplasty as described may provide a temporary solution for active patients with symptomatic early wrist arthritis who are not candidates for salvage wrist surgery. [26] (10.1055/s-0033-1338255)
[L4] Radiographic classification of SLAC wrist has moderate reliability and reproducibility, whereas classification of SNAC wrist has limited reliability. [27] (10.1177/1753193413484629)
[Paper] Staging systems for SNAC wrist lack agreement. [28] (10.1007/s12593-012-0062-2)
[L5] Surgical intervention markedly improves hand and wrist function for many rheumatoid patients. [29] (10.5435/jaaos-d-20-00102)
[L4] Reviewing multiview radiographs more commonly yielded Vender stage 3 osteoarthritis classification. [30] (10.1177/1558944720937359)
[L4] Delayed-onset ulnar neuropathy at the wrist can occur 12 to 30 years after conservatively treated distal radius fractures with malunion and DRUJ arthritis. [31] (10.1016/j.jhsa.2009.11.005)
[L4] SNAC wrists differ from SLAC wrists in exhibiting a decreased sagittal lunotriquetral angle, indicating a distinct pathomechanism of carpal instability. [34] (10.1186/s12891-025-08652-6)
[L5] While outcomes are generally favorable for therapeutic surgeries like arthrodesis and arthroplasty, further study is required to determine the best indications for ulnar head arthroplasty. [36] (10.1016/j.jht.2013.12.002)
[L1] We found no clinically meaningful differences between the neuromuscular exercise therapy program and range-of-motion training in the treatment of wrist osteoarthritis at 6 and 12 months. [39] (10.1186/s12891-025-09463-5)
[L3] In the early stages of HOA, there is a functional deficit associated with a reduced muscle activity of the wrist muscles during manual activities. [40] (10.1016/j.jht.2019.12.010)
[L3] The Simmen classification of wrist destruction in rheumatoid arthritis is useful in early disease in about 50% of cases and provides reasonably reliable identification of wrists at significant risk of becoming severely unstable, though the false-negative rate is substantial. [44] (10.1054/jhsb.1999.0196)
[L3] The authors prefer proximal row carpectomy for SLAC wrists with preserved capitate head cartilage due to socio-economic benefits, lower complication rates, and procedural ease. [46] (10.1177/1753193408087116)
[L4] With CT as the reference method, MRI showed moderate sensitivity and good specificity and accuracy for detection of erosions in rheumatoid arthritis and healthy wrist bones, while radiography showed very low sensitivity. [49] (10.1186/ar2378)
[L3] Subjective radiographic grading of the radioscaphoid joint was unable to detect mild arthritis but was able to distinguish between mild and moderate/severe arthritis. [50] (10.1007/s11552-013-9522-9)
[L4] Arthroscopic synovectomy of the wrist can provide pain relief and functional improvement with control of synovitis in 75% of rheumatoid wrists that have not responded to medication. [51] (10.1016/j.jhsa.2014.04.022)
[L3] Bone density was greater at the capitolunate joint, the radial styloid, and the radiolunate joint in SNAC wrists compared to controls. [52] (10.2106/jbjs.22.01350)
[L3] Computed tomography is more sensitive than conventional radiography for detecting bone erosions in rheumatoid arthritis. [53] (10.1186/1471-2474-14-265)

References

[1] Surgical management of osteoarthritis of the hand and wrist. Journal of Hand Therapy. 2022. DOI: 10.1016/j.jht.2022.01.001

[2] Current Concepts in the Surgical Management of Rheumatoid and Osteoarthritic Hands and Wrists. Hand Clinics. 2011. DOI: 10.1016/j.hcl.2010.09.003

[3] A systematic review of outcomes of wrist arthrodesis and wrist arthroplasty in patients with rheumatoid arthritis. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420953683

[4] Case Series: Closing Wedge Radial Osteotomy for Scaphoid Nonunion and Scaphoid Nonunion Advanced Collapse (SNAC) Wrists. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100448

[5] Trapeziectomy for basal thumb osteoarthritis does not increase the risk of developing wrist osteoarthritis in the long term. Journal of Orthopaedic Surgery and Research. 2021. DOI: 10.1186/s13018-021-02856-x

[6] Diagnostic Considerations for Monoarticular Arthritis of the Hand and Wrist. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.04.010

[7] Patterns of osteoarthritis of the wrist: a single-centre observational cohort study. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934241275450

[8] Prediction of Wrist Prognosis in Patients With Early Rheumatoid Arthritis According to Radiographic Classification. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.01.016

[9] Clinical Outcomes of Total Wrist Arthroplasty in Patients With Rheumatoid Arthritis: Minimum 10-Year Follow-Up Study. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.03.002

[10] Four-Corner Fusion and Scaphoid Excision Using Headless Compression Screws for SLAC and SNAC Wrist Deformities. Techniques in Hand & Upper Extremity Surgery. 2011. DOI: 10.1097/bth.0b013e3181f60fec

[11] Comparing radial styloid size between osteoarthritic and healthy wrists: a pathoanatomical three-dimensional study. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416669261

[12] Midterm Patient-Reported Outcomes in Wrist Denervation for Post-Traumatic Arthritis. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.02.023

[13] Surgical Management of Wrist Arthritis Is Linked to Increased Carpal Tunnel Syndrome/Carpal Tunnel Release Risk: Rethinking Preoperative Evaluation. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.01.013

[14] Patient satisfaction and outcomes of partial wrist denervation in inflammatory arthritis. Clinical Rheumatology. 2019. DOI: 10.1007/s10067-019-04645-8

[15] Ten-Year Minimum Follow-Up of 4-Corner Fusion for SLAC and SNAC Wrist. HAND. 2016. DOI: 10.1177/1558944716681949

[16] Prevalence and Associated Factors for Primary Osteoarthritis of the Scaphotrapeziotrapezoid, Radiocarpal, and Distal Radioulnar Joints in the Japanese General Elderly Population. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2023.05.009

[17] Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes. Journal of Wrist Surgery. 2019. DOI: 10.1055/s-0039-1688939

[18] Systematic Review of Total Wrist Arthroplasty and Arthrodesis in Wrist Arthritis. Journal of Wrist Surgery. 2018. DOI: 10.1055/s-0038-1646956

[19] Clinical Outcomes of Arthrodesis and Arthroplasty for the Treatment of Posttraumatic Wrist Arthritis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.02.013

[20] Classifications in Brief: Watson and Ballet Classification of Scapholunate Advanced Collapse Wrist Arthritis. Clinical Orthopaedics & Related Research. 2018. DOI: 10.1097/corr.0000000000000451

[21] Arthrodesis of the Wrist with Bioabsorbable Fixation in Patients with Rheumatoid Arthritis. Journal of Hand Surgery. 2002. DOI: 10.1054/jhsb.2002.0806

[23] Long‐term patient reported outcomes of elbow, wrist and hand surgery for rheumatoid arthritis. International Journal of Rheumatic Diseases. 2018. DOI: 10.1111/1756-185x.13340

[24] Revision rate and long-term outcome after partial wrist denervation in wrist osteoarthritis. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934261425490

[25] The treatment of arthritis of the wrist. The Bone & Joint Journal. 2015. DOI: 10.1302/0301-620x.97b10.35717

[26] A Minimal Wrist Arthroplasty for Early Wrist Osteoarthritis. Journal of Wrist Surgery. 2013. DOI: 10.1055/s-0033-1338255

[27] Reproducibility of radiographic classification of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist. Journal of Hand Surgery (European Volume). 2013. DOI: 10.1177/1753193413484629

[28] Scaphoid Nonunion Advanced Collapse Classifications: A Reliability Study. Journal of Hand and Microsurgery. 2012. DOI: 10.1007/s12593-012-0062-2

[29] Collaboration in Hand Surgery: Experiences From Silicone Arthroplasty in Rheumatoid Arthritis, Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness, Wrist and Radius Injury Surgical Trial, and Surgery of the Ulnar Nerve. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-20-00102

[30] A Reliability Study of Multiplanar Radiographs for the Evaluation of SNAC Wrist Arthritis. HAND. 2020. DOI: 10.1177/1558944720937359

[31] Delayed-Onset Ulnar Neuropathy at the Wrist Associated With Distal Radioulnar Joint Arthritis After Radius Malunion: Report of Two Cases. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.11.005

[34] Computer-aided three-dimensional analysis of carpal alignment in scaphoid nonunion advanced collapse wrists: A comparative study with scapholunate advanced collapse and healthy wrists. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08652-6

[36] Update on the surgical treatment for rheumatoid arthritis of the wrist and hand. Journal of Hand Therapy. 2014. DOI: 10.1016/j.jht.2013.12.002

[39] Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09463-5

[40] Impairment of electrical activation of wrist flexor and extensor muscles during gripping and functional activities in the early stage of hand osteoarthritis: A cross-sectional study. Journal of Hand Therapy. 2021. DOI: 10.1016/j.jht.2019.12.010

[44] The Simmen Classification of Wrist Destruction in Rheumatoid Arthritis. Journal of Hand Surgery. 1999. DOI: 10.1054/jhsb.1999.0196

[46] Proximal Row Carpectomy Versus Four-Corner Arthrodesis as a Treatment for SLAC (Scapholunate Advanced Collapse) Wrist. Journal of Hand Surgery (European Volume). 2008. DOI: 10.1177/1753193408087116

[49] Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography. Arthritis Research & Therapy. 2008. DOI: 10.1186/ar2378

[50] Joint Space Height Correlates with Arthroscopic Grading of Wrist Arthritis. HAND. 2013. DOI: 10.1007/s11552-013-9522-9

[51] Long-Term Results of Arthroscopic Wrist Synovectomy in Rheumatoid Arthritis. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.04.022

[52] Quantitative 3-D CT Demonstrates Distal Row Pronation and Translation and Radiolunate Arthritis in the SNAC Wrist. Journal of Bone and Joint Surgery. 2023. DOI: 10.2106/jbjs.22.01350

[53] Validity of a computer-assisted manual segmentation software to quantify wrist erosion volume using computed tomography scans in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2013. DOI: 10.1186/1471-2474-14-265