Early synovectomy and reconstructive procedures not only improve the function of the hand but also prevent further destruction of these joints by the rheumatoid arthritis. Frequently by judicious use of tourniquet time, definitive surgical care can be provided for the thumb, wrist, and a number of joints of the fingers during the same surgical procedure. As much mobility as possible in the unaffected joints and the joints not operated on should be obtained by careful dressing and plaster splintage. Frequent supervision of postoperative exercises and the use of both dynamic and nocturnal splints are essential for satisfactory results.