Clinical Experiences of Rheumatoid Hand Deformity

Shin, Woo Jin; Ahn, Hee Chang

Abstract

Rheumatoid arthritis is a chronic inflammatory disease of unknown etiology characterized by involvement of the synovial tissiues. Its diverse involvement can be demonstrated in the hand, where several anatomical structures can be affected simultaneously. The frequency of rheumatoid arthritis is increasing in Korea due to the development of diagnostic method and changing life style. The purpose of this study is to present our experience in surgical procedure designed to correct rheumatoid hand deformity. This study included 9 patients' rheumatoid hand deformity reconstruction from March, 1997 to November, 2001. Their ages ranged from 18 years to 67 years. The mean age of the patients were 36-years-old. Sex distribution was female dominant (7 : 2 ratio) and mean follow-up time was 12 months. Of the 27 involved fingers, There were boutonniere deformity in 13 fingers, swan neck deformity in 5 fingers and extensor tendon rupture in 5 fingers and thumb deformity in 4 fingers. All of these surgical procedures fall into one of these five groups; (1) synovectomy, (2) tenosynovectomy, (3) tendon surgery, (4) arthroplasty, (5) arthrodesis. In 9 patients, we obtained successful outcome after reconstruction for rheumatoid hand deformity. The correction of joint deformity was relatively satisfactory. Improvement of joint movement and relief of pain were obtained with better cosmetic result. No specific postoperative complication happened. Although we experienced a few cases, we concluded that the reconstructive surgery of rheumatoid hand deformity must be preformed by appropriate operative method based on the disease status, location and severity of hand deformities, patients' expectation, in order to get the best result.