Insufficient flexion of the metacarpophalangeal joint of the little finger following Swanson silicone arthroplasty for rheumatoid arthritis.
Twenty-one patients with rheumatoid arthritis who underwent Swanson metacarpophalangeal (MP) arthroplasty from 1994 to 1999 were assessed for active flexion of individual MP joints an average of 59 months (range 27-114 months) postoperative. Published articles of Swanson MP arthroplasty were reviewed. Experienced hand surgeons were surveyed regarding outcomes of metacarpophalangeal arthroplasty. The MP joint of the little finger displayed significantly less flexion than that of the middle and index finger. Seven of eight published studies which present active MP flexion by individual digit demonstrated less flexion in the little finger compared to the index, middle, and ring finger. Half of surgeons surveyed reported that MP range of motion is shifted toward a more extended position, that MP flexion is limited in the ulnar digits, and that an implant that encourages MP flexion would be helpful. Our experience with this cohort, a review of published literature, and a survey of international experts suggest that Swanson arthroplasty frequently results in a range of flexion of the MP joint of the little finger that may be insufficient for its principal functions.
Bogoch
Earl R
ER
Department of Surgery, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. bogoche@smh.toronto.on.ca.
Escott
Benjamin G
BG
Judd
Maria G P
MG
J Hand Surg Br. 2001 Jun;26(3):229-34
11386773
J Hand Surg Br. 1997 Feb;22(1):90-3
9061536
J Bone Joint Surg Am. 1986 Feb;68(2):206-9
3944159
Scand J Plast Reconstr Surg Hand Surg. 1999 Dec;33(4):433-8
10614754
J Rheumatol. 2000 Jun;27(6):1395-402
10852260
Scand J Plast Reconstr Surg Hand Surg. 1996 Jun;30(2):145-50
8815985
J Hand Surg Am. 2000 Sep;25(5):796-816
11040295
J Hand Surg Br. 1993 Feb;18(1):81-91
8382250
Clin Orthop Relat Res. 1984 Apr;(184):156-63
6705340
J Bone Joint Surg Am. 2003 Oct;85(10):1869-78
14563791
J Rheumatol. 2002 Dec;29(12):2477-83
12465138
J Hand Surg Am. 2005 Nov;30(6):1276-81
16344188
J Bone Joint Surg Am. 1993 Jan;75(1):3-12
8419388
J Hand Surg Am. 2004 Jul;29(4):646-53
15249089
J Hand Surg Br. 2005 Feb;30(1):3-7
15620484
J Hand Surg Br. 2000 Dec;25(6):601-3
11106528
Surg Clin North Am. 1968 Oct;48(5):1113-27
4879121
J Hand Surg Am. 1993 May;18(3):504-11
8515024
J Hand Surg Am. 1990 Mar;15(2):240-3
2324451
J Bone Joint Surg Am. 1975 Jun;57(4):484-9
1141257
J Hand Surg Br. 2005 Feb;30(1):8-13
15620485
Acta Orthop Scand. 1999 Apr;70(2):109-15
10366907
J Hand Surg Am. 1986 May;11(3):333-9
3711605