What is Ulnar Deviation?

Ulnar deviation is a progressive malformation of the joints at the bottom of the fingers. The knuckles begin to become malformed and tend to make the fingers shift toward the outside of the hand, toward the pinkie. Mild ulnar deviation may not require treatment and is thought to be caused simply by aging.

Often, ulnar deviation is seen in patients with rheumatoid arthritis. As the knuckles continue to deteriorate and the fingers shift outward, function in the hands can be affected. Rheumatoid arthritis can also cause significant pain in the joints and this coupled with ulnar deviation can cause complete lack of function.

Rheumatoid arthritis is a progressive illness with no real cure. The goal of treating ulnar deviation is to use soft splints that will allow a person to keep movement in the fingers while keeping the joints from progressing into further malformation. Generally, unless the condition is severe in the elderly, it is not treated by splinting the joints.

Splints used for ulnar deviation tend to be removable, so one can shower or wash dishes without getting them wet. They do tend to begin to smell badly after frequent wear. If one does not have sensitive skin, an odor remover like Febreze® can be used to keep the braces or splints from becoming too odorous.

Some cases of ulnar deviation may result from mild congenital, or present at birth, malformations. If the ulnar deviation is slight it may go unnoticed and is not likely to progress. It may occasionally be seen with other defects of the wrists and hands, which may necessitate surgery to help a person improve their hand and wrist function.

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