Ulnar Drift of the Fingers in Rheumatoid Disease: TREATMENT BY CROSSED INTRINSIC CENDON TRANSFER

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Twenty-five patients in whom crossed intrinsic transfers, in addition to other soft-tissue procedures, were utilized to correct ulnar-drift deformity are presented.The results in these twenty-five patients are compared with those in a control group of sixty-seven comparable patients in whom identical operations were carried out, except that intrinsic transfers were not done. The postoperative occurrence of ulnar deviation was significantly decreased when the transfer was added to the operation; but, in the fingers so treated, there was a tendency for a swan-neck deformity to develop.Twenty patients had the procedure as recommended by Straub. Five patients were operated on utilizing a new site for the transferred ulnar-intrinsic tendon, the distal end of the radial collateral ligament. This procedure was based on a biomechanical experiment which indicated that transfer to this site produced less flexor or extensor force and hence appeared to be less likely to produce an intrinsic contracture or a swan-neck deformity.

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