Surgical correction scleroderma hand deformity

The picture (A) shows bilateral severe hand deformities in a patient with systemic sclerosis. Preoperatively, the patient required the use of both hands to grasp a moderately sized object. The preoperative radiograph (B) shows severe metacarpophalangeal hyperextension deformities combined with fixed proximal interphalangeal joint flexion contractures. The patient underwent metacarpal head resections with proximal interphalangeal fusions. The postoperative radiograph (C) shows the resections with K-wire fixation. Three years postoperatively, the radiograph (D) shows spontaneous remodeling of the metacarpal heads.