title: Surgical reconstruction of an unstable rheumatoid thumb deformity. A case report.
abstract: 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.
authors.affiliation: Institut de la main, clinique Jouvet, 6, square Jouvenet, 75016 Paris, France. Electronic address: gwenole.kermarrec@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Kermarrec
authors.affiliation: Institut de la main, clinique Jouvet, 6, square Jouvenet, 75016 Paris, France. Electronic address: renata_paulos@yahoo.com.
authors.forename: R
authors.initials: R
authors.lastname: Paulos
authors.affiliation: Institut de la main, clinique Jouvet, 6, square Jouvenet, 75016 Paris, France. Electronic address: d.leviet@gsante.fr.
authors.forename: D
authors.initials: D
authors.lastname: Le Viet
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000601:surgery*; D005260:Female; D006226:Hand Deformities / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D013933:Thumb / Q000002:abnormalities* / Q000601:surgery
keywords: Bone-ligament-bone; Ligamentoplastie; Ligamentoplasty; Os-ligament-os; Pouce; Rheumatoid; Rhumatoïde; Thumb