Comparative study between perichondrial and perichondrio-costochondral graft in arthroplasty of the proximal interphalangeal joint of the fingers

Abstract

Sequelae of intra-articular fractures of the proximal interphalangeal joint (P.I.P.) are often incongruency of the articular surfaces, subluxation and deformity. This leads to post-traumatic arthrosis with painful stiffness and/or instability. Impairment and disability can be significant with involvement of the index finger in particular, function is impaired by decreased pinch strength. With involvement of the middle, ring or small fingers, grip strength is more likely to be drecreased. The initial trauma is frequently severe, involving the skin and tendons and it usually occurs in a young, active patient who needs a mobile painless and stable joint. It is critical that all conservative therapeutic efforts to regain joint motion are exhausted before considering surgical intervension. Capsulotomy is usually indicated and applied to the pathology involving only the joint capsule. Because the loss of joint motion is usually multifactorial capsulotomy frequently combined with other surgical procedures, such as tenolysis and release of soft tissue contractures. When faced with damaged articular surfaces of the P.I.P. joint, selection of the reconstructive technique requires a careful consideration of the condition of the injured joint and adjacent joints,