[Hand surgery in musicians with rheumatoid arthritis].

Hand surgery in musicians and hand surgery of the rheumatoid hand are main subjects, beside others, of the Hand Surgical Department of the DRK-Clinic in Baden-Baden/Germany, clinically as scientifically, too. There are some special aspects of surgery of the hand in musicians with rheumatoid arthritis. Between 1980 and 2001, seven musicians with this inflammatory disease (3.8 % of all 185 musicians, gathered up to April 2001 in our musician's data bank) did seek help. Among these patients, we performed surgery in five musicians (four professionals, one semi-professional), but altogether 18 operations have been performed in these five musicians. Three of these five musicians were able to continue their original musical activity for many years despite their rheumatoid arthritis, one of them switched from soloist to teaching activity, one we lost to follow up. In musicians, individual considerations about the indication, the type of surgery and its details must be made pre-operatively. These may depend upon the instrument played and which hand or finger is affected. If possible, the expected results of surgery should be assessed during a preoperative recitation, using static or dynamic test-splints or plasters and having the musician play with these external devices.