SILASTIC METACARPOPHALANGEAL JOINT ARTHROPLASTY IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Two hundred sixty-four patients with rheumatoid arthritis were treated with 901 Swanson silastic arthroplasties of the metacarpophalangeal j oints. Average followup was 8 years with a minimum of 2 years, Preoper ative ulnar deviation averaged 45 degrees and improved to an average o f 15 degrees postoperatively, Active flexion are averaged 40 degrees p reoperatively and 50 degrees postoperatively, an increase of 10 degree s, The extensor lag postoperatively improved to 10 degrees from 50 deg rees preoperatively, placing the are of metacarpophalangeal joint moti on between 10 degrees and 60 degrees flexion, Complications included d ehiscence and delayed wound healing (2%), superficial infection (0.5%) , deep infection (3%), and prosthetic fracture (14%), Subjectively, mo st patients thought that their postoperative function was improved, Th is was thought to be attributable in part to the correction of the uln ar deviation deformity of the fingers, and the shifting of the are of motion of the metacarpophalangeal joints to one allowing increased met acarpophalangeal extension, thereby improving the opening capacity of the digits and the overall function of the hand.