Impact of Simulated Proximal Interphalangeal Arthrodeses of All Fingers on Hand Function

Purpose

To evaluate the impact of simulated proximal interphalangeal (PIP) arthrodeses on hand performance and to assess the resulting compensatory metacarpophalangeal (MCP) joint motions in healthy subjects.

Methods

Fifteen healthy subjects were tested under 2 conditions: (1) with unrestricted distal interphalangeal, PIP, and MCP joints and (2) with the PIP joint fixed at 40° of flexion in all 4 fingers of 1 hand and unrestricted MCP and distal interphalangeal joints. Subjects performed the Jebsen hand function test and 13 activities of daily living. Perceived difficulty in performing tasks was assessed with a study-specific questionnaire. The motion of each finger was monitored using a motion analysis system.

Results

The average time to complete the Jebsen test did not increase significantly with simulated PIP arthrodesis, nor did subjects perceive the tasks to be more difficult. Activities of daily living tasks requiring power grasp did not show significant increases in MCP flexion or abduction. Precision handling tasks requiring greater PIP joint flexion did show increased MCP flexion and were associated with greater perceived difficulty.

Conclusions

Our study showed a minimal overall impact from simulated arthrodeses of all 4 fingers at the PIP joints in 40° of flexion when measured by selected lower-demand activities of daily living in healthy subjects. Precision handling tasks that normally use higher degrees of PIP joint flexion, however, were perceived to be more difficult to perform and required greater compensatory motion at the MCP joints. This study does not address directly the impairment that patients with generalized hand arthritis may experience after PIP joint arthrodesis.

Type of study/level of evidence

Prognostic, Level I.

Key words:  PIP arthrodesis , MCP motion , hand function , hand motion