What’s ulnar deviation?

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Ulnar deviation is a joint malformation that causes fingers to move towards the outside of the hand, often seen in rheumatoid arthritis patients. Soft splints can slow progression, but surgery is not recommended.

Ulnar deviation is a progressive malformation of the joints on the underside of the fingers. The knuckles begin to buckle and tend to move the fingers towards the outside of the hand, towards the little finger. A mild case may not require treatment and is thought to be caused simply by aging.
Often, this type of disfigurement is seen in patients with rheumatoid arthritis. As the knuckles continue to deteriorate and the fingers move outward, hand function may be impaired. Rheumatoid arthritis can also cause significant pain in your joints, which can contribute to problems with your hands.

Rheumatoid arthritis is a progressive disease with no real cure. The goal of ulnar deviation treatment is to use soft splints that allow a person to maintain movement in the fingers while keeping the joints from further malformation. Generally, unless the condition is severe in the elderly, it is not treated with joint immobilization.

The splints used to treat this problem tend to be removable, so you can shower or do the dishes without getting them wet. However, they can get dirty, particularly with a buildup of sweat, and start to smell bad. If the wearer does not have sensitive skin, an odor remover spray can be used to prevent the appliance or splints from becoming too smelly.

Some cases of ulnar deviation may result from mild congenital deformities, present at birth. If the problem is minor, it may go unnoticed and is not likely to progress. It can occasionally be seen with other defects of the wrists and hands, which may require surgery to help the individual improve their hand and wrist function.

Surgery to correct this deviation alone is rarely attempted. Since the cause is most often rheumatoid arthritis, surgery can actually progress the condition more quickly and may cause more pain. At this point, the medical community only offers splinting or braces as a way to slow progression.




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