Distal Inter Phalangeal Joint Arthritis : Functional Outcome and Results of Tendon Interpositional Arthroplasty

Dr Deepak Chaudhary; Dr Yasir Ali Khan

Volume : V, Issue : XI, November - 2016

Distal Inter Phalangeal Joint Arthritis : Functional Outcome and Results of Tendon Interpositional Arthroplasty

Dr Deepak Chaudhary, Dr Yasir Ali Khan

Abstract :

Objective:To evaluate the clinical outcome of managing distal inter-phalangeal joint arthritis by using excisional arthroplasties with soft-tissue interposition to provide pain-free joint with adequate range of motion and preserving the bone stock. Design:Prospective clinical study with 12 months of follow-up. Materials and Methods:This prospective clinical study was conducted at Eras Lucknow Medical College and Hospital , Lucknow (UP) India and included patients with distal inter-phalangeal (DIP) joint arthritis. Interpositional excisional arthroplasty was performed by using extensor retinaculum/ palmaris longus tendon in all patients. To maintain desired alignment in the reconstructed digit an axial K wire was applied for 3 weeks. After removal of K-wire a Mallet splint was applied for another 3 weeks. Active range of motion exercises were performed afterward. Clinical assessment was done at 3, 6 and 12 months postoperatively. Results:Twenty digits of fifteen patients suffering from DIP arthritis were included in the study. Out of twenty digits all the 16 fingers & four thumbs, achieved good range of motion with no complication except in 1 digit i.e. 5% of digits or 6.66% of patients who needed re-exploration of finger for retained suture without any documentary infection. All patients (100%) had significant pain relief with mean visual analogue scale score of 2/10�SD at 3 months and 0/10 at 1-year follow-up. All achieved significant range of motion and satisfaction with postoperative surgical outcome. Conclusion: Interpositional excisional arthroplasty provides adequate range of motion along with preservation of bone stock in patients suffering from DIP joint arthritis.