Title: Joint Replacement Surgery for Complicated Fractures of Small Joints of Hand: Results of Five-Year Follow-up Study
Authors: Darpan Maroti Maheshgauri, Sandip Baheti, MD (Anaesth.), D Ortho
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.26
Abstract
Introduction: Complicated Intra articular fractures of fingers are prone to stiffness, chronic pain, deformities and post traumatic arthritis with conservative treatment. Attempts for fixation also result in a high incidence of joint stiffness, pain and secondary arthritis. Ideal treatment should avoid the above complications and provide an early mobilization of a stable and congruent joint. The purpose of this study was to investigate the results of complicated intra-articular fracture of the fingers treated with total joint replacement.
Methods and Materials: From January 2012 to December 2013 a total of eighteen joints (seventeen patients) with complicated intra-articular fracture of the fingers (PIP and MCP joints) were treated by total joint replacement using silicone implants. Of the 18 cases, 8 involved metacarpophalangeal joint, and 10 involved proximal interphalangeal joint. All patients were followed up for mean of 62 months and the results were assessed using total active motion (TAM) of fingers.
Results: Subjective, objective and radiographic results were evaluated. There was phalangeal shortening (4mm) in 1 case and rotation (> 15 degrees) in 1 case. Based on Total Active Motion Score (TAM), the overall rate of joint motion function was 87.1%.
Conclusion: Total joint replacement can be a reliable and effective option for treatment of complicated intra-articular fracture of the fingers.
Keywords: Complicated fractures, Joint Replacement, Metacarpo-phalangeal joint, Proximal interphalangeal joint.
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