title: Boutonniere rheumatoid thumb deformity.
abstract: The boutonniere deformity is the most common rheumatoid thumb deformity. It can be classified into early, moderate, and advanced types, depending on whether the deformity is passively correctable. Fifty-three patients with 74 procedures form the basis of these recommendations. The early type treated with metacarpophalangeal joint synovectomy and extensor pollicis longus rerouting have a high recurrence rate of 64%. Metacarpophalangeal joint fusion is the procedure of choice for the moderate type with isolated metacarpophalangeal joint involvement. Metacarpophalangeal joint arthroplasty is best suited for the low-demand, older patients with borderline proximal and distal joints. Interphalangeal joint releases done with metacarpophalangeal joint fusions have a high recurrence rate and are not recommended. In advanced cases metacarpophalangeal joint arthroplasty and interphalangeal joint fusion is our procedure of choice.
authors: New England Baptist Hospital, Boston, Mass.
authors: A
authors: A
authors: Terrono
authors: L
authors: L
authors: Millender
authors: E
authors: E
authors: Nalebuff
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis; D001178:Arthroplasty; D005384:Finger Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009068:Movement; D012008:Recurrence; D013933:Thumb / Q000503:physiopathology / Q000601:surgery*