Proximal Interphalangeal Finger Arthroplasty with Double Osteochondral Rib Graft. Case Report and Description of the Surgical Technique
Abstract
We present the case of a 27-year-old male patient with a gunshot wound and severe proximal interphalangeal joint injury in the ring finger of the right hand, treated with a double osteochondral rib graft. He had an exposed fracture and a lack of bone and cartilage stock in both the first and second phalanx. After the initial toilette, at 3 weeks, a proximal interphalangeal arthroplasty was performed with a double osteochondral rib graft protected by a Suzuki external distractor. The surgical technique is described in detail. At 10 weeks after surgery, an active interphalangeal joint flexion of 75º and active extension of -15º were verified, without articular instability. The patient returned to work at 3 months after surgery, with no residual pain (0 VAS score) and a DASH score of 14.2. Radiographs showed incorporated grafts without resorption and a congruent joint. This technique is valued for its low morbidity on the donor site and versatility for joint defect reconstructions. The limitations of our study are mentioned. The clinical casepresented obtained a satisfactory subjective and objective early functional outcome. Further complications cannot be ruled out.Downloads
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