Arthrodesis as a salvage for failed proximal interphalangeal joint arthroplasty.

Autor: Jones DB Jr; Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA., Ackerman DB, Sammer DM, Rizzo M
Jazyk: angličtina
Zdroj: The Journal of hand surgery [J Hand Surg Am] 2011 Feb; Vol. 36 (2), pp. 259-64. Date of Electronic Publication: 2010 Dec 24.
DOI: 10.1016/j.jhsa.2010.10.030
Abstrakt: Purpose: To review the rate of fusion, complications, and subjective outcome measures of proximal interphalangeal joint arthrodesis after failed implant arthroplasty.
Methods: We conducted a retrospective review identifying patients from 1990 to 2009 who underwent proximal interphalangeal joint arthrodesis for implant arthroplasty failure. All types of implants were included. We reviewed clinical notes and radiographs identifying patient history, implant type, revisions before arthrodesis, method of arthrodesis, rate of union, time to union, and complications. We used the Michigan Hand Outcomes Questionnaire to assess patients' function and perceived clinical outcome.
Results: A total of 13 joints in 8 patients (6 female, 2 male) identified with an average clinical follow-up of 6.5 years (range, 1.0-12.3 y) were available for study. The average time from joint replacement to salvage for all implant types was 9.3 years (range, 1.6-32.2 y). Eight of the 13 fingers achieved union. The average time to union was 5.8 months (range, 1-11 mo). Eight of 13 fingers underwent removal of K-wires, tension band, or both. Excluding hardware-related problems, there were 4 additional complications in 4 patients.
Conclusions: Salvage of failed proximal interphalangeal joint arthroplasty remains a challenging clinical problem. Although achieving solid fusion with arthrodesis is not completely reliable or without complication, patients' subjective and functional outcomes demonstrate fair to good results.
Type of Study/level of Evidence: Therapeutic IV.
(Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE