The first proximal interphalangeal joint (PIPJ) replacements were hinged devices with
single-axis motion. Newer implant arthroplasties of the PIPJ have anatomically designed
proximal phalangeal and middle phalangeal components. A need to create balanced forces
across the joint was the rationale for the semiconstrained PIPJ prosthesis, which
uses an anatomic design. These low-profile implants limit bone excision while preserving
the integrity of the collateral ligaments. Paramount in the success of this implant
is maintaining the integrity of the insertion of the central slip as it inserts on
the base of the middle phalanx. The proximal and middle phalanx should be broached
such that the largest implant can be press-fit in place. Greater stability is gained
with a collateral ligament-preserving implant. Patient selection should include those
patients with sufficient soft-tissue integrity. In general, patients with inflammatory
disorders, collateral ligament insufficiency, and acute or chronic PIPJ septic arthritis
are poor candidates for PIPJ surface replacement arthroplasty.
Key words
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Article info
Publication history
Accepted:
April 23,
2007
Received:
February 6,
2007
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
