Purpose:
Rheumatoid arthritis (RA) is a chronic inflammatory disease and it can cause spontaneous tendon rupture in hand. Tendon transfers are the preferred method of surgery in patients with rheumatoid arthritis. Darrach procedure (distal ulnar resection) is performed in cases of radial–ulnar joint pain and instability. Thus, we combined Darrach procedure and tendon transfer in order to decrease the risk of recurrent tendon rupture.

Materials and Methods:
During 2015 to 2018, five patients with extensor tendon rupture caused by rheumatoid arthritis had tendon transfer combined with Darrach procedure (distal ulnar resection). The donor tendon of tendon transfer included three cases of flexor digitorum superficialis (FDS) and two cases of extensor indicis proprius (EIP).

Results:
The post-operative course was smooth in all patients. All patients had improved finger extension during follow up. No further wrist instability and recurrent tendon rupture were noted.

Conclusion:
This report describes our experiences and good outcome with combined Darrach procedure and tendon transfer in the treatment of extensor tendon rupture in rheumatoid arthritis.

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