The fixed lupus hand deformity and its surgical correction

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Systemic Lupus Erythematosus (SLE) Research

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• Long-term SLE treatment often involves corticosteroids like prednisone.
• Hand deformities can significantly impair quality of life in SLE patients.

Observation:

• Three female SLE patients developed fixed hand deformities after over 10 years of disease.
• Deformities included irreducible metacarpophalangeal (MCP) subluxation/dislocation without joint destruction.
• Associated deformities included carpometacarpal dislocations, swan-neck, and Boutonniere deformities.

Findings:

• MCP joint deformities stemmed from soft tissue contractures, preserving joint cartilage.
• Metacarpal osteotomy and shortening effectively decompressed contracted soft tissues.
• Surgical intervention led to corrected hands and restored normal function in all patients.

Implications:

• Metacarpal osteotomy is a viable treatment for SLE-related hand deformities.
• Preservation of joint cartilage allows for successful soft tissue decompression.
• This approach improves hand function and patient quality of life in SLE.