Article

We report a retrospective series of 27 cases of composite island
homodigital distal interphalangeal joint to replace proximal destroyed
interphalangeal joint.
Results of our series are compared with other procedures
available in order to specify the place of pedicled articular transfers mainly
for the proximal interphalangeal joint which is recognized as the most important
joint in the finger. METHODS: The series included 27 cases of destroyed proximal
interphalangeal joints with preservation of the distal interphalangeal joint, the
flexor tendon and vascular pedicles. The mean age was 32 years, 26 male, all
manual workers. All fingers were concerned mainly the third (13 cases) and the
fourth (10 cases). RESULTS: No vascular failure. Pain quotation improved from 7
preoperatively to 2 postoperatively. Average flexion-extension motion arc was 43
degrees . The grip strength was 54% compared to the opposite side. The average
time off work was 7 months. Complications were few, all of them due to technical
imperfections underlining the difficulty of this procedure. This transfer
deserves his use due to the better mobility he gives compared to the other
techniques available. CONCLUSIONS: Reconstruction of important articular loss of
substance in a digit remains an unsolved problem, especially for the proximal
interphalangeal joint representing the anatomical and functional center of the
digit. However, in certain good indications, especially in emergency it deserves
to be used.
CI - Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS