Extensor Indicis Proprius Tenodesis to Correct Finger Ulnar Drift Deformity in Rheumatoid Arthritis

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Hand Surgery

Background:

• Rheumatoid arthritis (RA) commonly causes hand deformities, particularly affecting the metacarpophalangeal (MCP) joints.
• These deformities include volar subluxation and ulnar drift of the fingers.

Purpose of the Study:

• To evaluate the efficacy of Extensor Indicis Proprius (EIP) tenodesis in correcting ulnar deviation of the fingers in RA patients.
• To assess the long-term stability of the correction.

Main Methods:

• EIP tenodesis was performed on 10 hands (40 fingers) across 5 RA patients to correct ulnar deviation (digits II-V).
• Surgical outcomes were assessed at initial (3-4 months) and final (8-12 months) postoperative evaluations.

Main Results:

• Complete correction of subluxation/dislocation and near-complete correction of ulnar drift were achieved initially.
• Recurrence of ulnar deviation was noted in all digits by the final evaluation.

Conclusions:

• EIP tenodesis establishes a corrective force vector for finger alignment post-ulnar deviation surgery.
• While initially effective, long-term maintenance of corrected alignment requires further investigation.