Stabilization of Finger Ulnar Deviation in Rheumatoid Arthritis: Extensor Indicis Proprius Tenodesis

Ulnar deviation of fingers in rheumatoid arthritis is a common deformity that can markedly compromise hand function. These deformities also result in an aesthetic impairment that is often troubling to patients. A variety of surgical procedures have been recommended to correct the ulnar deviation, either at the wrist level or at the metacarpophalangeal (MCP) joints. We present a surgical technique that uses the extensor indicis proprius as a tenodesis across the dorsum of the MCP joints of the fingers. The technique can also be used in conjunction with other surgical procedures, including prosthetic replacement arthroplasties of the MCP joints. The procedure has been used in 6 patients. Ulnar deviation averaged 62° preoperatively and 15° postoperatively. All patients have been satisfied with the results.