[The rheumatic thumb].

Abstract

The thumb is one of the most frequent sites of rheumatoid arthritis (62% of patients). Two major deformities predominate: adductus thumb due to a predominant lesion of the trapezo-metacarpal joint (5% of cases) and, more importantly, Z deformity of the thumb due to a predominant lesion of the metacarpo-phalangeal joint (60% of cases). The surgical indications should be discussed in a loco-regional context, but also in a global context of polyarticular lesions and depend on the severity of the deformities. The results, globally useful and greatly appreciated by the patients, were studied in a series of 92 operated thumbs. Involvement of the thumb leads to deformities which, in the majority of cases, are responsible for major functional disorders. The functional adaptation associated with the absence of a parallel anatomo-clinical adaptation must obviously be noted, but the restoration of the function of the thumb, the most important digit of the hand, would appear to be essential in the loco-regional and global context of rheumatoid arthritis.