Rheumatoid

Deformity

Ulna drift & volar dislocation

Causes of MCPJ Deformity

Ulna Drift / Ulna Dislocation

1.  Physiological

Epidemiology

Extremely common

- 90% by 10 years have wrist problems

Principles

Landsmeer 1961

- treat wrist at same time as treat fingers or will recur

Frequently combine procedures

- synovectomy

- tendon transfer

- ulna procedure

Issueshttps://www.boneschool.com/sites/default/files/styles/avif_conversion/p…" width="200" align="right" loading="lazy">

Rotator cuff

- often deficient

Bone stock

- often deficient

Glenoid

- often posterior version 

Management

Options

1.  TSR

Indications

- cuff intact

Rheumatoid Arthritis Diagnostic Criteria

1987 American College of Rheumatology 

Need 4/7 (MAX RANS)

1. Morning Stiffness

2. Arthritis of 3 areas > 6/52

3. Xray changes

4. Rh factor

5. Arthritis of Hand > 6/52

6. Nodules

7. Symmetric Arthritis > 6/52