Summary

Psoriatic arthritis can present with significant hand and wrist deformity and dysfunction [1]. The development of newer biological therapies has resulted in higher rates of remission [2]. However, surgical intervention is still indicated in pain, disability, and severe deformation cases. The management of patients with rheumatic diseases has a controversial history, characterized by rheumatologists and hand surgeons debating the efficacy of surgical interventions. Some surgeons attribute the controversial results to “too little and too late” referral of patients from rheumatologists [3]. While the availability of new and more effective medication has changed the indications and postponed surgical intervention, it is important to remember that surgery is often more effective when used preventively in the early stages than when forced to salvage. In the following case, we present a patient with psoriatic arthritis who presented with advanced-stage debilitating hand deformity and was treated surgically.