Operative correction of swan-neck and boutonniere deformities in the rheumatoid hand.

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Abstract

[Indexed for MEDLINE] 8. Arthrosc Tech. 2023 Jun 19;12(7):e1155-e1159. doi: 10.1016/j.eats.2023.03.004. eCollection 2023 Jul. Arthroscopic Complete Synovectomy of the Proximal Interphalangeal Joint of the Finger. Lam KH(1), Lui TH(1). Author information: (1)Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong. Rheumatoid arthritis is characterized by hypertrophic synovitis destroying the involved joints. If medical treatment fails to control the synovitis, synovectomy is a worthwhile prophylactic procedure that might help to delay further distention of the joint capsule and ligament. Synovitis of the proximal interphalangeal joint is usually performed by an open approach. The major complication is scar development around the interphalangeal joint, leading to considerable joint contracture. Arthroscopy of the proximal interphalangeal joint is a minimally invasive technique that can eliminate the risk of joint contracture associated with open surgery. The purpose of this Technical Note is to report the technical details of arthroscopic complete synovectomy of the proximal interphalangeal joint of the finger. This procedure is indicated in patients with rheumatoid synovitis of the proximal interphalangeal joint of the finger recalcitrant to medical treatment. It is contraindicated in case of an established boutonniere or swan-neck deformity, the presence of large dorsal synovial cysts, advanced degeneration of the joint, the presence of joint instability, or a fresh skin lesion near portals. © 2023 The Authors. DOI: 10.1016/j.eats.2023.03.004 PMCID: PMC10391246