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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

1999, Number 4

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An Med Asoc Med Hosp ABC 1999; 44 (4)

Swan-neck deformity of the fingers in rheumatoid arthritis

Fernández VJM, Juárez RCS, Schenk PJ

Language: Spanish
References: 9
Page: 163-168
PDF size: 438.60 Kb.


ABSTRACT

The swan neck deformity is characterized by proximal interphalangeal joint (PIP) hyperextension and distal interphalangeal joint (DIP) flexion. Patients have functional impairment and it is progressive. From 1971 to 1999 in the ABC Hospital, 33 patients: 29 female and 4 male, with 48 finger deformities were studied. According to Nalebuff and Millender classification were 5 cases type I, twelve type II, 13 type III, eleven type IV and seven type V. Flexor synovectomy and volar plasty was performed in 2 cases with type II deformity, and failed by recurrence. Four fingers with type III deformity were treated by arthroplasty resection of the metacarpophalangeal joint with intrinsic cubital release without improvement. In type IV and V we performed 16 PIP fusion, all with improvement in grasp. Just one case of superficial infection was recorded. The rheumatologist must know this classification in order to determine the type of deformity, and refer early to hand surgeons in order to soft tissue procedures. When the deformity is advanced PIP fusion is a definitive procedure that improves the patients quality of life.


REFERENCES

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  6. Nalebuff et al. Rheumatoid arthritis in the hand an wrist: Operative hand surgery. 2nd Ed. New York: Churchill Livingstone, 1988: 1726-1735.

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  8. Tonkin MA et al. Lateral band translocation for swan neck deformity. J Hand Surg 1990; 17a (2): 260-267.

  9. Zancolli EA. Swan neck deformities. In: Lamb DW (ed). The paralyzed hand. Edinburgh: Churchill Livingstone 1987: 163-165.




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