ROLE FOR SURGICAL EXCISION OF GOUTY TOPHI IN IMPROVING HAND FUNCTION.

Ahmad Fazly ABD RASID, Mohd Yazid BAJURI, Rasyidah REHIR

Department of Orthopaedic and Traumatology,Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Kuala Lumpur, Malaysia.

ABSTRACT

Gout is a painful disorder of purine degradation with resulting hyperuricemia leading deposition of monosodium urate crystals in major joints of the lower limbs, classically the first metatarsophalangeal joint or better known as podagral. Gout may also leads to other systemic complications such as nephrolithiasis, renal impairment and involvement of other part of connective tissue. Pharmacological therapy with dietary avoidance of certain food is the main stay of treatment. Surgery is only indicated for the patients with joints or cutaneous deposits of urate crystal causing significant restriction of hand or limb function, skin ulceration or for compressive peripheral neuropathy. We report a case of a 61 year old Malay gentleman, who presented with polyarticular tophaceous gouty arthritis affecting both of his upper limbs, for which surgery with excision of the tophaceous gouty deposit led to improvement in his right hand function.

Key words: Acquired hand deformities, Gout, Gouty arthritis, Surgery, Uric acid

Correspondence: Associate Professor Dr Mohd Yazid Bajuri, Department of Orthopaedic and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre,

56000, Cheras, Kuala Lumpur, Malaysia.

Phone number: +60172771000; Fax number: +60391456674

Email address: ezeds007@yahoo.com.my

Brunei Int Med J. 2019;15:9-12