Rheumatoid hand surgery--update.

Many varied and bizarre deformities of the hand are encountered in rheumatoid arthritis. The surgical procedures commonly performed generally fall into five groups, including: synovectomy, tenosynovectomy, tendon surgery, arthroplasty, and arthrodesis. Hand surgery plays an important role in the management of patients with rheumatoid arthritis. The surgeon trained in the techniques described should be part of any team managing the patient with arthritis, not a "course of last resort" called upon when all else fails.