ABSTRACT
The thumb column is one of the most frequently affected sites in rheumatoid arthritis; involvement occurs in 60-81% of patients with rheumatoid arthritis (Clayton 1962, Brewerton 1966, Ratliff 1971, Eiken 1972, Inglis et al 1972, Salgeback et al 1976, Brumfield and Conaty 1980, Swanson et al 1981, Nalebuff 1984, Tubiana and Toth 1984, Alnot 1987). Thumb deformities are often associated with deformities of the fingers and wrist and, once the decision to proceed with surgical treatment has been made, not only should the involved joints of the hand and wrist be considered, but the entire upper extremity must be addressed. When determining appropriate treatment for the rheumatoid thumb, all extrinsic (soft tissue) as well as intrinsic (bone and joint) factors contributing to thumb function must be assessed. We will describe the different thumb lesions commonly found in rheumatoid arthritis, their mechanisms and the different surgical treatments.
