- 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.