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Surgical reconstruction of an unstable rheumatoid thumb deformity. A case report.
Chirurgie de la Main 2015 September
The thumb is frequently impaired in rheumatoid arthritis. This leads to major disability in affected patients. Through a clinical case, we describe a reconstructive strategy for a three-joint adduction thumb deformity that caused instability of the interphalangeal and metacarpophalangeal joints, without cartilaginous lesion. Ulnar collateral ligament destruction was treated by a bone-ligament-bone graft at the interphalangeal joint and by a Littler ligamentoplasty at the metacarpophalangeal joint. The trapeziometacarpal lesion was treated by trapeziectomy in combination with suspension ligamentoplasty. Clinical and radiological assessments at 22 months of follow-up revealed good outcomes. This technique is a new option to include in the reconstructive treatment for thumb instability, particularly when caused by rheumatoid arthritis.
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