Preventive surgery - tenosynovectomy and synovectomy.

The goal of preventative rheumatoid hand surgery is the eradication of the diseased synovium or tenosynovium before irreparable joint or tendon destruction occurs. Although there is general agreement that both dorsal and flexor tenosynovectomy are reliable and effective procedures to prevent the complications of tenosynovitis, the case for synovectomy is less well established. We have discussed the indications for both tenosynovectomy and synovectomy and described the surgical techniques used for dorsal tenosynovectomy and flexor tenosynovectomy in the wrist, palm, and digits. In addition, the treatment of both extensor and flexor tendon ruptures has been presented.