Thirty-two rheumatoid elbow joints in 25 patients which had undergone synovectomy and excision of the radial head have been studied from the point of view of pattern of joint involvement and the efficacy of surgery. In this group of patients there was a significant trend towards affection of proximal joints occurring earlier in the course of the disease than distal joints. There was a high incidence of involvement of wrist and knee. There was a positive relationship between dominance and the elbow affected. Pain diminished in all cases after surgery, and there was a significant improvement in hinge movement but no significant improvement in range of forearm rotation though it was less painful. Single lateral approach gave satisfactory exposure and is favoured. Complciations of the procedure were few.
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