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Proximal interphalangeal phalanx prosthesis

B Hohendorff, J Franke, C K Spies, L P Müller, C Ries
OBJECTIVE: Arthrodesis of the proximal interphalangeal joint of fingers in a functional and pain-free position. INDICATIONS: Primary and secondary osteoarthritis, traumatic joint destruction, posttraumatic malposition, instability, joint destruction due to infection, irreparable extensor and/or flexor tendon lesion, recurrent flexion deformity in Dupuytren's disease, arthritis (e. g., rheumatoid arthritis, psoriatic arthritis), failed resection arthroplasty, failed prosthesis, congenital disorder (e...
October 25, 2016: Operative Orthopädie und Traumatologie
B Hohendorff, W Zhang, L P Müller, C Ries
BACKGROUND: There are many indications that long-term stability of the Ascension(®) pyrocarbon proximal interphalangeal (PIP) total joint is not attained by osseointegration but by appositional bone formation. Accordingly, good locking by cortical bone for sufficient primary stability is necessary in order to avoid prosthesis loosening before enough new bone has been formed. The size of the proximal component of the Ascension(®) PyroCarbon PIP total joint and thus cortical anchorage and primary stability depend on the morphology of the proximal finger phalanx and, especially, on the isthmus of the distal medullary canal...
October 2015: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Bernd Hohendorff, W Zhang, K J Burkhart, L P Müller, C Ries
INTRODUCTION: The Ascension PyroCarbon proximal interphalangeal (PIP) total joint is used in osteoarthritis of the PIP finger joint. No systematic study of the positioning of this prosthesis and its relation to proximal and middle phalanx morphology has yet been reported. MATERIALS AND METHODS: Positioning of the proximal and distal components of the Ascension PyroCarbon PIP total joint was radiographically analysed in 152 human cadaver fingers. RESULTS: Ideal implant position in the axis of the phalanx and with contact of the implant head with bone in both the frontal and sagittal planes was seen in only 33 % of the phalanges...
February 2015: Archives of Orthopaedic and Trauma Surgery
C Ries, W Zhang, K J Burkhart, W F Neiss, L P Müller, B Hohendorff
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...
July 2014: Journal of Hand Surgery, European Volume
Takuji Iwamoto, Noboru Matsumura, Kazuki Sato, Shigeki Momohara, Yoshiaki Toyama, Toshiyasu Nakamura
PURPOSE: To assess the outcomes of our technique involving oblique headless compression screw for arthrodesis of the thumb interphalangeal joint and the distal interphalangeal joints of the other digits. METHODS: A total of 28 joints (19 thumb interphalangeal and 9 distal interphalangeal) in 23 patients with a mean age of 65 years (range, 58-74 y) were retrospectively analyzed. All operations were performed with the Acutrak2 micro-screw. After the resection of synovium and joint cartilage by a dorsal approach, a 0...
December 2013: Journal of Hand Surgery
Benjamin J Ahern, Brent L Showalter, Dawn M Elliott, Dean W Richardson, Liberty M Getman
OBJECTIVES: To compare the in vitro biomechanical properties of a 4.5 mm narrow locking compression plate (PIP-LCP) with 2 abaxially located transarticular screws and a 4.5 mm limited contact dynamic compression plate (LC-DCP) with 2 abaxially located transarticular screws using equine pasterns. STUDY DESIGN: Experimental. Paired in vitro biomechanical testing of 2 methods for stabilizing adult equine forelimb PIP joints. ANIMAL: Adult equine forelimbs (n = 8 pairs)...
April 2013: Veterinary Surgery: VS
Katherine T Criner, Asif M Ilyas
Chronic dislocations of the proximal interphalangeal (PIP) joint pose a significant treatment challenge. Chronically dislocated PIP joints can experience several changes to the articular cartilage including pressure necrosis, degeneration, and the development of secondary incongruence. Moreover, chronic dislocation allows the edema and hemorrhage from soft tissue trauma to develop into collateral ligament fibrosis and inelastic scar formation. Similarly, chronic dislocations associated with a fracture at the base of the middle phalanx can also experience changes in the form of joint incongruency, bony resorption, or malunion formation...
December 2011: Techniques in Hand & Upper Extremity Surgery
Thomas M Sweets, Peter J Stern
BACKGROUND: Pyrolytic carbon resurfacing arthroplasty of the proximal interphalangeal joint has been reported to provide favorable results. The purpose of this study was to evaluate the effectiveness of pyrolytic carbon joint replacement at an average follow-up of fifty-five months. METHODS: A retrospective review of thirty-one arthroplasties of the proximal interphalangeal joint performed by a single surgeon in seventeen patients with interphalangeal joint osteoarthritis was conducted...
August 3, 2011: Journal of Bone and Joint Surgery. American Volume
Umit Kantarci, Selim Cepel, Halil Buldu
Amputations involving ten digits are very rare because of different lengths of the digits. A 34-year-old man working in a printing house presented one hour after guillotine amputation involving all ten digits. Surgery was initiated 80 minutes after admission and took seven hours. Under axillary anesthesia, the operation was performed by two teams each consisting of two microsurgeons and two assistants. Replantation was completed without the use of any skin graft or flap. Fingertip examination showed poor arterial circulation in the second, third, and fourth digits of the left hand after 24 hours of replantation and surgical exploration was performed, during which anastomosis of the ulnar digital artery of the second digit was re-established and a Y-shaped vein graft was placed at the level of the third web to restore revascularization of the third and fourth digits...
2010: Acta Orthopaedica et Traumatologica Turcica
Peter M Murray
The first proximal interphalangeal joint (PIPJ) replacements were hinged devices with single-axis motion. Newer implant arthroplasties of the PIPJ have anatomically designed proximal phalangeal and middle phalangeal components. A need to create balanced forces across the joint was the rationale for the semiconstrained PIPJ prosthesis, which uses an anatomic design. These low-profile implants limit bone excision while preserving the integrity of the collateral ligaments. Paramount in the success of this implant is maintaining the integrity of the insertion of the central slip as it inserts on the base of the middle phalanx...
July 2007: Journal of Hand Surgery
C Sokolow
INTRODUCTION: The most commonly used type of proximal interphalangeal joint prosthesis is a silicone spacer. A variety of other types of prosthesis have been used over the years. The originalty of our new prosthesis lies in its mode of bone anchorage; namely osseointegration. DESCRIPTION OF PROSTHESIS AND OPERATIVE TECHNIQUE: Two titanium covered screws are inserted in the medullary canals of the proximal and middle phalanges. A connecting hinge allows movement from 0 degrees to 100 degrees...
December 2006: Chirurgie de la Main
Omer Ozkan, H Ege Ozgentaş, Tunç Safak, Ozlenen Dogan
Although ring avulsion injuries are not common, when they do occur their management is still a challenging problem in reconstructive surgery. In this report, we present our microsurgical experiences with Kay's class III and IV ring avulsion injuries. A total of six patients with ring avulsion injuries were operated on between 2000 and 2004. Three patients were in class III with inadequacy of both arterial and venous circulation, and the remaining three were in class IV. The study consisted of four male and two female patients whose ages ranged from 23 to 43 (mean age 32)...
2006: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
V Pistre, P Pelissier, A Ballanger, D Martin, J Baudet
Five patients were successfully treated with a modified "on-top-plasty" technique, in which a finger stump is lengthened by transfer of an adjacent amputation stump with a reverse blood flow fingerstump. This technique can be performed in the acute phase or as a secondary procedure. A conventional on-top-plasty can be performed by transfer of a partially amputated index or ring finger to the "top" of the proximal phalanx of an amputated middle finger. Alternatively, the transferred part may be used in an intercalated fashion to reconstruct the middle phalanx, using a prosthesis to reconstruct the proximal interphalangeal joint...
June 2002: Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand
N R Fahmy, A Lavender, C Brew
Access to the proximal interphalangeal joint of the finger for arthroplasty is difficult without detaching its stabilizers or dividing the tendons that cross it, which then require repair and slow rehabilitation. We describe a method that conserves both, so facilitating post-operative rehabilitation.A C-shaped incision is made on the dorsum of the finger. The lateral bands of the extensor expansion are separated from the central slip proximally to the extensor hood. They are then retracted to expose the condyles of the proximal phalanx, which are excised...
June 2001: Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand
R Doshi, C Yeh, M LeBlanc
Current prosthetic hands, although functional, have the potential of being improved significantly. We report here the design and development of a novel prosthetic hand that is lighter in weight, less expensive, and more functional than current hands. The new prosthesis features an endoskeleton embedded in self-skinning foam that provides a realistic look and feel and obviates the need for a separate cosmetic glove. The voluntary-closing mechanism offers variable grip strength. Placement of joints at three locations (metacarpophalangeal and proximal and distal interphalangeal) within each of four fingers affords realistic finger movement...
October 1998: Journal of Rehabilitation Research and Development
H E Ash, A Unsworth
The proximal and middle phalanges from 83 proximal interphalangeal joints (PIPJs) were set in clear plastic and sectioned in the transverse plane leaving the heads whole. The sections were cleaned, shadowgraphed and measured. The medullary canals were marked on sagittal and frontal plane shadowgraphs of the intact bones and analysed. The information was then used in the design of a surface replacement prosthesis for the PIPJs. The main dorsal surface of the proximal phalanx (PP) was found to be angled to the longitudinal baseline of the bone by a mean of 5...
1997: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
H E Ash, A Unsworth
The bones from 83 proximal interphalangeal joints (PIPJs) were dissected in order to determine the shape and size of the articular surfaces. The bones were modelled in acrylic dental bone cement and the original bones and replicas were then sectioned and shadowgraphed. Dimensions were taken from these shadowgraphs to be used in the design of a surface replacement prosthesis for the PIPJ. It was found that the bi-condylar heads of the proximal and middle phalanges were circular in the sagittal plane as was the base of the middle phalanx...
1996: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
A Hollister, D J Giurintano, W L Buford, L M Myers, A Novick
The axes of rotation of the thumb interphalangeal and metacarpophalangeal joints were located using a mechanical method. The interphalangeal joint axis is parallel to the flexion crease of the joint and is not perpendicular to the phalanx. This offset of the axis with respect to the phalanx explains the ulnar deviation and pronation that occurs with flexion of the interphalangeal joint. The metacarpophalangeal joint has 2 fixed axes: a fixed flexion-extension axis just distal and volar to the epicondyles, and an abduction-adduction axis related to the proximal phalanx passing between the sesamoids...
November 1995: Clinical Orthopaedics and related Research
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