Proximal interphalangeal joint silicone arthroplasty for posttraumatic arthritis

The long-term results of 16 silicone implant arthroplasties following sever e destruction of the proximal interphalangeal joint and surrounding soft ti ssue in 14 patients were evaluated. Two implants were revised (1 arthrodesi s 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 fu nction and the ability to perform activities of daily living scored 73 on a verage (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 deg rees to 9 degrees; median, 4 degrees). Rotational deformity, either radial or ulnar, averaged 8 degrees (range, 0 degrees to 32 degrees; median, 4 deg rees). Pinch strength of the operated finger on average was 75% of the oppo site nonoperated finger (range, 14% to 164%; median, 70%). Possible statist ical correlation between objective and subjective results was evaluated. Su bjectively, most patients were satisfied because they were pain free. Objec tively, notable rotational deformity, alignment deviation, and loss of pinc h strength and range of motion were observed, but these did not correlate w ell with the subjective assessment. Silicone implant arthroplasty for postt raumatic arthrosis should be used for those cases in which associated adhes ions may be corrected by simple tenolysis, allowing for active range of mot ion shortly following arthroplasty. Even in these cases, the objective resu lts 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.).