Outcomes of the Volar Method in Proximal Interphalangeal Joint Arthroplasty.
J Hand Surg Asian Pac Vol. 2018 Mar;23(1):26-32
Authors: Duncan SFM, Smith AA, Renfree KJ, Dunbar RM, Merritt MV
BACKGROUND: Most hand surgeons use a dorsal method for proximal interphalangeal (PIP) joint implant arthroplasty. Nonetheless, a volar method affords the benefit of no disturbance to the extensor mechanism, thus permitting early initiation of energetic vary of movement. We examined our ends in sufferers who underwent PIP joint arthroplasty by way of a volar method.
METHODS: Utilizing a retrospective chart assessment, we evaluated the outcomes of sufferers present process PIP joint arthroplasty by a volar method between 2001 and 2005 by three fellowship-trained hand surgeons at our establishment. The indication for surgical procedure was PIP joint ache with radiographic proof of joint destruction. Variables included implant sort, analysis, affected digit(s), preoperative and postoperative vary of movement, and issues. Hand remedy was initiated on postoperative day three or four.
RESULTS: Over the 5 years, 25 PIP joints had been changed in 18 girls and a couple of males with the volar method. Replacements consisted of 14 floor substitute prostheses, 9 pyrocarbon prostheses, and a couple of silicone prostheses. The common age of sufferers at prosthesis implantation was 64 years (vary, 39-75 years). Prostheses had been positioned in 1 index, 12 lengthy, 7 ring, and 5 small digits. Common follow-up interval was 33 months (vary, 24-69 months). Preoperative diagnoses had been osteoarthritis (14), rheumatoid arthritis (four), and posttraumatic arthritis (2). Preoperative whole arc of movement averaged 42° (vary, zero° extension to 80° flexion); postoperative whole arc of movement averaged 56° (vary, -10° extension to 90° flexion). Issues comprised 1 swan neck deformity, 1 deep an infection, 1 dislocation (early), and a couple of free implants with flexion contractures. Seventeen sufferers had minimal or no ache at their final follow-up go to.
CONCLUSIONS: PIP joint arthroplasty might be efficiently applied by a volar method with varied implant sorts and has outcomes similiar to the printed outcomes of the dorsal method.
PMID: 29409422 [PubMed – in process]