Insufficient Flexion of the Metacarpophalangeal Joint of the Little Finger Following Swanson Silicone Arthroplasty for Rheumatoid Arthritis

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• 作者：Earl R. Bogoch (1)
  Benjamin G. Escott (2)
  Maria G. P. Judd (3)
  
• 关键词：Metacarpophalangeal joint ; Arthroplasty ; replacement ; finger ; Arthritis ; rheumatoid ; Range of motion ; articular ; Little finger
• 刊名：HAND
• 出版年：2008
• 出版时间：March 2008
• 年：2008
• 卷：3
• 期：1
• 页码：24-29
• 全文大小：147KB
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• 作者单位：Earl R. Bogoch (1)
  Benjamin G. Escott (2)
  Maria G. P. Judd (3)
  
  1. Department of Surgery, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
  2. Mobility Program Clinical Research Unit, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
  3. Canadian Health Services Research Foundation, 1565 Carling Avenue, Suite 700, Ottawa, ON, K1Z 8R1, Canada
  

文摘

Twenty-one patients with rheumatoid arthritis who underwent Swanson metacarpophalangeal (MP) arthroplasty from 1994 to 1999 were assessed for active flexion of individual MP joints an average of 59?months (range 27-14?months) postoperative. Published articles of Swanson MP arthroplasty were reviewed. Experienced hand surgeons were surveyed regarding outcomes of metacarpophalangeal arthroplasty. The MP joint of the little finger displayed significantly less flexion than that of the middle and index finger. Seven of eight published studies which present active MP flexion by individual digit demonstrated less flexion in the little finger compared to the index, middle, and ring finger. Half of surgeons surveyed reported that MP range of motion is shifted toward a more extended position, that MP flexion is limited in the ulnar digits, and that an implant that encourages MP flexion would be helpful. Our experience with this cohort, a review of published literature, and a survey of international experts suggest that Swanson arthroplasty frequently results in a range of flexion of the MP joint of the little finger that may be insufficient for its principal functions.