Anatomy Q. H/o RA. hand flexed and ulnar deviated

[Krasmyc]

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woman with R. A presents with ulnar deviation and contracture of the hand with fingers flexed. which muscle will the surgeon manipulate so that patient can regain the functionality of the hand and can extend the fingers.
options:
Flexor Digiti minimi
Flexor Digitorum Profundus
Flexor Digitorum Superficalis
Flexor Carpi Ulnaris
Extensor Digitorum

I am confused which one to go with?
on one hand FDS act on Proximal Interphalangeal vs FDP act on distal.

 

[deleted564496]

I'm not entirely sure, but RA doesn't affect the DIP's, so I'd go with FDS.

 

[megaman123]

I agree with Kapooya. Flexor Carpi Ulnaris mm can ulnar deviate the hand, but I don't know how you could manipulate that to fix the problem... cut it maybe?

 

[Transposony]

but I don't know how you could manipulate that to fix the problem...

Re-position the tendon.

 

[dfib slim]

I'd say extensor digitorum. Slipping of the tendon causes boutonniere deformity which flexes the PIP joint. To fix it you manipulate the tendon back into place, not cut it.

 

[pd1112]

I'd say extensor digitorum. Slipping of the tendon causes boutonniere deformity which flexes the PIP joint. To fix it you manipulate the tendon back into place, not cut it.

Agree it is extensor digitorum, but I think the ulnar deviation + flexion contracture is ulnar drift, not Boutonnière deformity, which would have flexion of PIP with hyperextension of DIP and/or MCP.

 

[enhancers]

Agree it is extensor digitorum, but I think the ulnar deviation + flexion contracture is ulnar drift, not Boutonnière deformity, which would have flexion of PIP with hyperextension of DIP and/or MCP.

I was reading this site for ulnar drift but they do not mention muscles, if i am reading it correctly.
http://www.hindawi.com/journals/ijr/aa/648073/

 

[pd1112]

I was reading this site for ulnar drift but they do not mention muscles, if i am reading it correctly.
http://www.hindawi.com/journals/ijr/aa/648073/

By manipulating the tendons, you are indirectly manipulating the muscle. I can't think of any relevant procedures, particularly involving the answer choices given, in which the actual muscle belly is directly manipulated. You're reading too much into the question.

http://www.orthobullets.com/basic-science/9085/rheumatoid-arthritis
http://www.wheelessonline.com/ortho/ulnar_drift_of_mp_joints

 

[Doc M87]

Why not Flexor Carpi Ulnaris? Its the only muscle that causes ulnar drift. And check this article too.
http://www.pjms.com.pk/issues/aprjun107/article/article20.html