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. 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 shift outward, function in the hands can be affected. Rheumatoid arthritis can also cause significant pain in the joints, which can contribute to problems using the hands.
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 further malformation. Generally, unless the condition is severe in the elderly, it is not treated by splinting the joints.
Splints used to treat this problem tend to be removable, so one can shower or wash dishes without getting them wet. They can get dirty, however, particularly with a build up of sweat, and begin to smell bad. If the wearer does not have sensitive skin, an odor remover spray can be used to keep the braces or splints from becoming too smelly.
Some cases of ulnar deviation may result from mild congenital deformities, which are present at birth. If the problem 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 require surgery to help the individual improve his or her hand and wrist function.
Surgery to correct this 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 the progression.