Arthrodesis of Proximal Interphalangeal joint

Question 1

What are the indications for arthrodesis of PIJ?

Answer 1

High ring bone
Pastern luxation
Fracture second phalanx
Septic arthritis of pastern

Question 2

What are is the main principle of PIJ arthrodesis?

Answer 2

Removal of all articular cartilage to maintain rigid stability in the joint

Question 3

What is the best surgical approach for arthrodesis of the PIJ?

Answer 3

Trans-articular lag screws and dorsal plate
- Enhance stability improved comfort postop, shorter time in a cast, shorter return to function, shorter hospitilization time, less peri-articular new bone formation on dorsal aspect

Question 4

What is the procedure for the trans-articular surgery?

Answer 4

Inverted T incision on the proximal and middle 1/3 of the proximal phalanx ending 2cm proximal to coronary band

Question 5

Which tendon is transected in the trans-articular approach surgery for arthrodesis?

Answer 5

CDE with an inverted V incision

Question 6

How many holes are placed in P1 vs. P2?

Answer 6

Two holes in P1 (glide hole)

One hole in P2 (thread hole)

Question 7

Why are rads important when performing arthrodesis surgeries?

Answer 7

To ensure proper placement of surgical equipment

Question 8

What is the preferred technique for PIP joint arthrodesis?

Answer 8

Plate application (increases stability)