SOFT-TISSUE RECONSTRUCTION FOR RHEUMATOID SWAN-NECK AND BOUTONNIERE DEFORMITIES - LONG-TERM RESULTS

Ninety-two fingers with rheumatoid swan-neck deformity were treated wi th dorsal capsulotomy and lateral band mobilization. An initial increa se of 55 degrees of motion into flexion was noted, but this proximal i nterphalangeal motion deteriorated over time. Of 15 fingers followed a t 3 and 12 months, there was a mean loss of 17 degrees of the early po stoperative flexion. Nineteen fingers with rheumatoid boutonniere defo rmity were treated with central slip reconstruction. The results were unpredictable, with only modest improvement in the proximal interphala ngeal extension, which deteriorated over time. The authors now recomme nd arthrodesis for most severe rheumatoid boutonniere deformities.