Soft tissue surgery in rheumatoid arthritis of the hand

All surgery in patients with rheumatoid arthritis of the hand involves care ful consideration and planning of the soft tissue component of the disease. The planning must include acknowledgment of the patient's functional requi rements and surgical requirements. Multiple surgeries are common in patient s with rheumatoid disease and must be planned carefully to avoid conflictin g postoperative rehabilitation programs. Joint replacement and other surger y are only an adjunct to the soft tissue treatment. The progressive nature of rheumatoid arthritis is not a barrier to early surgery and may prolong t he function of the patient. The logical approach to the surgical requiremen ts is discussed and specific soft tissue surgeries are described. Some deta ils of specific surgical techniques also are included.