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Journal of Hand Surgery (British and European Volume)
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*Joint Disorders
*Rheumatoid Arthritis
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Articles

Restoration of Metacarpophalangeal Extension of the Thumb in Inflammatory Arthritis

C. A. MANUEDDU
E. R. BOGOCH
D. E. HASTINGS

From the Division of Orthopaedic Surgery, the Wellesley Hospital, University of Toronto, Toronto, Canada

Correspondence: Dr C. Manueddu, Clinique d'Orthopédie, 24 Rue Micheli-du-Crest, Hôpitaux Universitaires de Genève, 1211 Genève 14, Switzerland.

Nine patients (11 cases) with inflammatory arthritis who had an early boutonnière deformity of the thumb treated by rerouting of the extensor pollicis longus tendon were reviewed.

Preoperatively, all patients complained of pain, disability in activities of daily living and extensor lag of the MP joint ranging from 10 to 60°. At a mean follow-up of 38 months, nine thumbs had equal active and passive MP joint extension. Two thumbs had a moderate extensor lag. Functional strength assessment demonstrated no deleterious effect of the procedure in the operated compared to the non-operated thumb. Subjectively, all patients but one were satisfied.

This procedure appeared to correct or to limit the progression of the deformity. A deficit of interphalangeal extension in five patients may require a modification of the procedure to tighten the extensor pollicis longus distal to the MP joint.

Journal of Hand Surgery (British and European Volume), Vol. 21, No. 5, 633-639 (1996)
DOI: 10.1016/S0266-7681(96)80147-1
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