Extensor digiti minimi tendon transfer to prevent recurrent ulnar drift

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Hand Surgery

Background:

• Rheumatoid arthritis frequently causes ulnar drift, a common deformity.
• Existing surgical treatments for ulnar drift often result in recurrence.

Purpose of the Study:

• To evaluate the efficacy of extensor digiti minimi tendon transfer in preventing recurrent ulnar drift.
• To assess the functional outcomes of this tendon transfer in patients with rheumatoid arthritis.

Main Methods:

• The extensor digiti minimi tendon insertion was relocated to a dorsal-radial position.
• This tendon transfer was performed on 28 patients over 6 years.
• Outcomes were evaluated more than 1 year post-surgery.

Main Results:

• Metacarpal phalangeal joint extension averaged 52 degrees post-surgery.
• No recurrence of ulnar drift was observed in any patient.
• Slight hyperextension (<5 degrees) occurred in about half of patients but was not functionally problematic.

Conclusions:

• Extensor digiti minimi tendon transfer is an effective method to prevent recurrent ulnar drift in rheumatoid arthritis.
• This technique is recommended for patients undergoing metacarpal phalangeal joint replacement for rheumatoid arthritis.