Results of the Volar Approach in Proximal Interphalangeal Joint Arthroplasty
| Autor: | Ross M. Dunbar, Marianne V. Merritt, Scott F.M. Duncan, Anthony A. Smith, Kevin J. Renfree |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Joint Prosthesis medicine.medical_treatment Radiography Hand therapy 030230 surgery 03 medical and health sciences Postoperative Complications 0302 clinical medicine Finger Joint medicine Humans Arthroplasty replacement Range of Motion Articular book Aged Retrospective Studies 030222 orthopedics business.industry General Medicine Middle Aged Arthroplasty Numerical digit Surgery body regions Arthroplasty Replacement Finger book.journal Female Implant Interphalangeal Joint Range of motion business |
| Zdroj: | The Journal of Hand Surgery (Asian-Pacific Volume). 23:26-32 |
| ISSN: | 2424-8363 2424-8355 |
| Popis: | Background: Most hand surgeons use a dorsal approach for proximal interphalangeal (PIP) joint implant arthroplasty. However, a volar approach offers the advantage of no disturbance to the extensor mechanism, thus allowing early initiation of active range of motion. We examined our results in patients who underwent PIP joint arthroplasty via a volar approach.Methods: Using a retrospective chart review, we evaluated the outcomes of patients undergoing PIP joint arthroplasty through a volar approach between 2001 and 2005 by 3 fellowship-trained hand surgeons at our institution. The indication for surgery was PIP joint pain with radiographic evidence of joint destruction. Variables included implant type, diagnosis, affected digit(s), preoperative and postoperative range of motion, and complications. Hand therapy was initiated on postoperative day 3 or 4.Results: Over the 5 years, 25 PIP joints were replaced in 18 women and 2 men with the volar approach. Replacements consisted of 14 surface replacement prostheses, 9 pyrocarbon prostheses, and 2 silicone prostheses. The average age of patients at prosthesis implantation was 64 years (range, 39–75 years). Prostheses were placed in 1 index, 12 long, 7 ring, and 5 small digits. Average follow-up period was 33 months (range, 24–69 months). Preoperative diagnoses were osteoarthritis (14), rheumatoid arthritis (4), and posttraumatic arthritis (2). Preoperative total arc of motion averaged 42° (range, 0° extension to 80° flexion); postoperative total arc of motion averaged 56° (range, –10° extension to 90° flexion). Complications comprised 1 swan neck deformity, 1 deep infection, 1 dislocation (early), and 2 loose implants with flexion contractures. Seventeen patients had minimal or no pain at their last follow-up visit.Conclusions: PIP joint arthroplasty can be successfully implemented through a volar approach with various implant types and has outcomes similiar to the published results of the dorsal approach. |
| Databáze: | OpenAIRE |
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