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The present study examined the effectiveness of a 6‐week experimental program of splinting and joint protection education in reducing the progression of the early boutonniere deformity. Nine patients with mild or moderately reducible boutonniere deformities were randomized into experimental and control groups and followed for 1 year. Improvements in active extension of the proximal interphalangial joint for patients in the experimental program suggest that early initiation of a nonsurgical intervention can reduce or reverse progression of the boutonniere deformity in some patients with rheumatoid arthritis. Although the number of patients was small, we conclude that early splinting and joint protection education may limit the anatomical and functional derangements of boutonniere deformity in the rheumatoid hand.

SUMMARY A calorimetric study in a patient with a pachydermoperiostosis points to a peripheral (possibly mitochondriat) cause for abnormalities in heat production. An improvement in the patient's appearance was obtained by plastic surgery.

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