Proximal interphalangeal joint silicone arthroplasty for posttraumatic arthritis

The long-term results of 16 silicone implant arthroplasties following severe destruction of the proximal interphalangeal joint and surrounding soft tissue in 14 patients were evaluated. Two implants were revised (1 arthrodesis and 1 amputation) and are not included in the results. On a visual analog scale of 0 to 100, the subjective evaluation relating to the quality of function and the ability to perform activities of daily living scored 73 on average (range, 0-100; median, 75). The range of active motion compared with the opposite side ranged from 0% to 100% (average, 47%; median, 56%). The lateral deviation, either radial or ulnar, averaged 4 degrees (range, 0 degrees to 9 degrees; median, 4 degrees). Rotational deformity, either radial or ulnar, averaged 8 degrees (range, 0 degrees to 32 degrees; median, 4 degrees). Pinch strength of the operated finger on average was 75% of the opposite nonoperated finger (range, 14% to 164%; median, 70%). Possible statistical correlation between objective and subjective results was evaluated. Subjectively, most patients were satisfied because they were pain free. Objectively, notable rotational deformity, alignment deviation, and loss of pinch strength and range of motion were observed, but these did not correlate well with the subjective assessment. Silicone implant arthroplasty for posttraumatic arthrosis should be used for those cases in which associated adhesions may be corrected by simple tenolysis, allowing for active range of motion shortly following arthroplasty. Even in these cases, the objective results of silicone arthroplasty may not be as good as its subjective outcome. (J Hand Surg 1999;24A:73-77. Copyright (C) 1999 by the American Society for Surgery of the Hand.).