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The Role of Upper Extremity Surgery in Patients with Joint Hypermobility/Ehlers Danlos Syndrome

Ehlers Danlos Syndrome (EDS) is thought to be rare, but 1/3 to 1/2 of women are significantly hypermobile and in the spectrum of patients with mild forms of EDS, and are at risk for the same pattern of upper extremity problems related to a combination of small joint instability, peripheral nerve compression, and tendon subluxation. These are all subtle problems that typically do not show on standard diagnostic tests, and also typically do not improve with standard treatment protocols, frustrating both the patients and the providers. The author describes the patterns of clinical problems involving the upper extremity that these patients present with, their anatomic basis, a protocol for assessing these patients, and the success with innovative surgical procedures that can provide reliable relief of pain, increased strength and greatly improved hand function.