title: Surgical Approaches to the Proximal Interphalangeal Joint.
abstract: The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Volar plate arthroplasty and corrective osteotomy for malunion about the PIP joint are also surgeries that may be required. The traditional approach to the PIP joint has been dorsal, which damages the delicate extensor apparatus with subsequent development of an extensor lag. This has led surgeons to explore volar and lateral approaches to the PIP joint. In this article, we describe each of these surgical approaches, discuss their advantages and disadvantages, and provide some guidance on which approach to choose based on the surgery that is to be performed.
authors.affiliation: Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA; Department of Hand and Reconstructive Microsurgery, National University Hospital, National University Health System, Singapore.
authors.forename: Andre Eu-Jin
authors.initials: AE
authors.lastname: Cheah
authors.affiliation: Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA. Electronic address: jyao@stanford.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yao
mesh_terms: D004210:Dissection / Q000379:methods*; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D019637:Orthopedic Procedures
keywords: Proximal interphalangeal joint; arthroplasty; corrective osteotomy; open reduction internal fixation