[Management of affected flexor tendons in rheumatoid arthritis of the hand]

The affection to the flexor tendons of the patient with rheumatoid arthritis represents a substantial rheumatic change in the hand, which is characterized by restriction of movement, ulnar deviation in the level of the metacarpophalangeal joint and palmar incomplete dislocation. Early treatment by removing any possible constriction areas in synovial proliferations in the area of the flexor pullies or a complete tendosynovectomy makes an extensive restitution possible. In the case of only one ruptured flexor tendon, it can be treated by the transfer of the neighboring superficialis tendon or a tendon transplant. If there are multiple ruptures, the results will be clearly worse in regard to movement and strength, whereby as a rule the result is seriously influenced by articular destruction. Therefore, an early tendosynovectomy and a preventive operation to the wrist have to be recommended.