HOSPITAL COURSE: The patient was appropriately worked up preoperatively and was taken to the operating room where index-finger-to-small-finger metacarpophalangeal joint arthroplasties were performed, as well as right small finger flexor tendon repair. The patient also underwent volar plate release at the right middle finger to small finger, and the patient also had intrinsic release at right ring finger. The patient tolerated the procedure well and was taken for recovery purposes. The patient was placed on stress-dose steroids perioperatively, which were tapered down. The patient was fitted with dynamic extension type of splint, by occupational therapy on postoperative day three and the patient tolerated this procedure well. After understanding the postoperative plan by the patient, it was determined to discharge the patient to a guest home.

FINAL DIAGNOSES

1. Rheumatoid arthritis, status post right wrist reconstruction.
2. Parkinson disease.

OPERATIONS

1. Arthroplasties, index finger, long finger, ring finger, and small finger of patient's [of patient's-omit] right hand.
2. Flexor tendon repair, right small finger.
3. Volar plate release over middle and ring finger.

PROCEDURES: Fitting with dynamic extension of splint over right upper extremity.

COMPLICATIONS: None.

DISCHARGE MEDICATIONS: The patient is to resume her previous medications. In addition, the patient may take Tylenol with codeine, two by mouth every four hours as needed for pain.

DISPOSITION AND FOLLOWUP: The patient will be sent to the guest house. The patient will follow up at the hand surgery service.