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Proximal Interphalangeal (PIP) Joint Implant Arthroplasty Using a Volar Approach
Proximal interphalangeal (PIP) joint arthroplasty can provide pain-free and functional restoration to the mobility and stability of the joint. In cases with less than 30 degrees of deviation in the coronal plane, silicone implant interposition arthroplasty canbe used. While a dorsal approach is used most frequently, post-operative immobilization of varying amounts of time are required to allow for healing of the extensor mechanism.
Although technically more demanding, the volar approach allows for immediate post-operative rehabilitation. In this case, a 65-year-old patient presented with painful osteoarthritis of the PIP joint of the right index finger, resulting in weakness of pinch and loss of motion. She has had a previous DIP arthrodesis. Plain radiographs revealed coronal deformity without sagittal malalignment, and 10-55 degrees of passive motion. A volar approach was recommended. This video describes the successful reconstruction
of the index PIP joint using silicone implant arthroplasty from a volar approach.
Drs Buterbaugh, Putnam, Fitzpartick, and Stepan debate the merits of LRTI, Suture button suspension arthroplasty, Suture suspension arthroplasty with or without an implant, and arthrodesis for management of thumb CMC arthritis
This video demonstrates the utility and surgical technique for radial forearm flap harvest, including step-by-step instructions as well as tips and tricks. Following this, the posterior interosseous artery flap is described in a similar fashion. Cadaveric dissection of both flaps is then demonstrated. This lab is from "The Complete Hand Surgeon: Flaps You Should Know After Fellowship (Lab)," recorded at the 74th
Annual Meeting of the ASSH in 2019
This video discusses management of FPL rupture in the rheumatoid patient. The author's preferred technique is FDS to FPL tendon transfer combined with open carpal tunnel release and flexor tenosynovectomy.
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