Title: Reconstruction of ankylosed Proximal Interphalangeal Joint of a Finger Using Conchal Cartilage
Authors: Dr Maksud Devale, Dr Rohit Munot, Dr Mukund Jagannathan
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.67
Abstract
Ankylosis of Proximal Interphalangeal Joint (PIPJ)of a finger can occur after intra-articular fractures, burns, degenerative conditions likerheumatoid arthritis. Not only are fingers with ankylosed PIP joints of little use for grip or grasp, but they are frequently injured because they do not follow the normal arc of the other fingers. An additional problem, though less so with the index finger, is the Quadriga effect, which can occur when profundus excursion is impaired with arthrodesis. Thus, ankylosis of Proximal Interphalangeal Joint of a finger in non-functional position can result in significant disability. Management of this problem varies from amputation to arthrodesis to arthroplasty. Many patients opt for arthroplasty as it improves range of motion and relieves pain. Proximal Interphalangeal Joint reconstruction has also been described using vascularised joint transfer and non vascularised autografts like perichondrium, costal cartilage.
We report 4 cases of Proximal Interphalangeal Joint ankylosis which were reconstructed using non vascularised conchal cartilage. The ankylosed portion of the joint was excised. Raw surfaces on either side were covered with conchal cartilage grafts. The grafts were fixed with sutures. Joint stability was achieved with PL grafts which were sutured on either side to periosteum covering the dorsal and volar aspects of the cartilage grafts.
We report here outcomes of the procedure with respect to pain, stability, range of motion and complications.
Keywords: Proximal interphalangeal joint ankylosis, conchal cartilage, arthroplasty.
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