[Primary metacarpophalangeal and proximal interphalangeal arthrosis of the hand. Indications and results of 27 DJOA arthroplasty].
The authors report 27 Digital Joint Arthroplasties (DJOA), implanted exclusively in cases of osteoarthritis, between 1985 and 1994. The metacarpophalangeal joint was involved in 8 cases and the proximal interphalangeal joint was involved in 19 cases in a series of 20 patients with a mean age of 58 years (49-84). The mean interval between the first clinical signs and the surgical operation was 34 months (12-72). An anterolateral incision was used in 5 cases for the PIP joint, and an anterior incision was used in one case for the MP joint. All other cases were operated via a dorsal incision. Two early complications were observed: septic ulceration of the skin and dislocation of the PIP prosthesis on the 8th day. Good results were obtained in terms of pain. Range of movement was only slightly improved by arthroplasty and exclusively in the extension sector. The range of movement of the MP joint increased from 35 degrees to 50 degrees, while the range of movement of PIP joint remained unchanged at 50 degrees with a slight displacement of 5 degrees towards the extension sector. This can be explained by the radiological follow-up of our implants which showed impaction of the prosthetic shaft during the first two postoperative years with appearance of signs of periarticular ossification. The results concerning range of movement and pain were analogous to those of other series in the literature, particularly with the use of Swanson implants. On the other hand, DJOA arthroplasty presents a low incidence of axial deviation problem (1 case out of 27). The authors are currently trying to improve the results of DJOA arthroplasty by creating a size 0 to suit anatomical requirements and by adopting the anterolateral incision to preserve the extensor apparatus in order to decrease postoperative flexion deformity.
Condamine
J L
JL
Service d'Orthopédie A, CHU côte de Nacre, Caen.
Fourquet
M
M
Marcucci
L
L
Pichereau
D
D
D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology; D007595:Joint Prosthesis / Q000009:adverse effects; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology; D010003:Osteoarthritis / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D012883:Skin Ulcer / Q000209:etiology; D013997:Time Factors