Soft tissue surgery in rheumatoid arthritis of the hand

All surgery in patients with rheumatoid arthritis of the hand involves careful consideration and planning of the soft tissue component of the disease. The planning must include acknowledgment of the patient's functional requirements and surgical requirements. Multiple surgeries are common in patients with rheumatoid disease and must be planned carefully to avoid conflicting postoperative rehabilitation programs. Joint replacement and other surgery are only an adjunct to the soft tissue treatment. The progressive nature of rheumatoid arthritis is not a barrier to early surgery and may prolong the function of the patient. The logical approach to the surgical requirements is discussed and specific soft tissue surgeries are described. Some details of specific surgical techniques also are included.