Cross intrinsic transfer for ulnar drift in the rheumatoid hand under wide awake local anesthesia No tourniquet - Surgical technique.

This article introduces a surgical technique for cross-intrinsic transfers (CIT) to correct ulnar drift in rheumatoid hands performed under wide-awake local anesthesia no tourniquet (WALANT). This approach allows real-time adjustment of tendon transfer tension and active patient participation in hand movements and deformity correction during the procedure. It can be combined with other surgeries such as prosthetic replacement arthroplasties of the MCP joints. The technique was applied to six patients, resulting in a significant reduction of ulnar deviation from an average of 70° preoperatively to 8° postoperatively. All patients reported high satisfaction with good outcomes.