Rheumatoid Arthritis: PIP Joint

- See:
        - Rheumatoid Boutonniere
        - RA
        - Swan Neck Deformity

- Arthrodesis: of PIP
    - expect improved key pinch strength w/ fusion of PIP joint of index finger;
    - arthroplasty of PIP joint of index is least successful results;
    - technique:
            - involves resection of joint surfaces are resected back to medullary bone, tightly coapted, and fixed w/ K wires;
            - bone grafting is used when necessary.
            - consider fusion w/ Herbert screw;
    - joints fused within six weeks and required only minimal external protection;

- Arthroplasty: of PIP
    - silicone arthroplasty may be used for ulnar digits;
    - ROM of 50-60 deg w/ satisfactory pain relief can be expected;
    - complications:
           - poor flexion following PIP joint arthroplasty (etiology);
                 - insertion of prosthesis which is to large;
                 - shortening of dorsal capsule closure;
                 - improper bone cuts
                 - flexor tenosynovitis
                 - volar plate adherence;

- Synovectomy of PIP joint:
    - indicated for isolated PIP joint synovitis, not for multiple joint involvement;
    - may prevent progressive deformity

Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis.

Resurfacing arthroplasty versus silicone arthroplasty for proximal interphalangeal joint osteoarthritis.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 20, 2012 2:24 pm