Correction of ulnar drift during silastic metacarpo-phalangeal joint arthroplasty

In previous published accounts of silastic replacement arthroplasty of the M.P. joint of the finger in rheumatoid disease, dynamic splintage has been used for up to six months after operation to ensure correction of ulnar drift. We have investigated two methods of surgical correction in a prospective trial in consecutive patients. No dynamic splintage was used. Both resulted in correction of ulnar drift from an average of 34 degrees (maximum 92 degrees) to 8 degrees (maximum 32 degrees) in 86 fingers. The two methods both corrected ulnar drift well, but crossed intrinsic transfer gave a better range of active movement and is recommended as an alternative to dynamic splintage.