title: Morphology of the proximal and middle phalanx of fingers with regard to the Ascension PyroCarbon PIP total joint.
abstract: The Ascension PyroCarbon prosthesis has been used in proximal interphalangeal joint osteoarthritis. The dimensions of the intramedullary distal metadiaphyseal canal (isthmus) of the proximal phalanx and the base of the middle phalanx of cadaver fingers were investigated radiographically (n = 304) and macroscopically (n = 152). In up to 30% of the phalanges, the isthmus was smaller than the stem of the smallest proximal component size. The distal component head was always smaller than the middle phalanx base. Insertion and success of the Ascension PyroCarbon prosthesis is strongly dependent on bone morphology. A critical examination of the isthmus in radiographs is recommended in planning. If the isthmus is clearly smaller than the smallest proximal component, insertion of the prosthesis could be inadvisable. A clear mismatch between the distal component and the middle phalanx base should be avoided due to the potential risk for late subsidence and failure of the prosthesis.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University of Cologne, Cologne, Germany christian.ries@uk-koeln.de.
authors.forename: C
authors.initials: C
authors.lastname: Ries
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University of Cologne, Cologne, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University of Cologne, Cologne, Germany.
authors.forename: K J
authors.initials: KJ
authors.lastname: Burkhart
authors.affiliation: Department of Anatomy I, University of Cologne, Cologne, Germany.
authors.forename: W F
authors.initials: WF
authors.lastname: Neiss
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University of Cologne, Cologne, Germany.
authors.forename: L P
authors.initials: LP
authors.lastname: Müller
authors.affiliation: Elbe Clinic Stade, Aesthetics and Plastic Surgery, Stade, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hohendorff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002102:Cadaver; D002244:Carbon; D005260:Female; D005384:Finger Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography
chemical_list: D001672:Biocompatible Materials; C009139:pyrolytic carbon; D002244:Carbon
keywords: Proximal interphalangeal joint; joint replacement; morphology; pyrocarbon