[Arthrotenolysis of the proximal interphalangeal joint of the fingers. Operative technique and results]. / Arthrotenolyse der Fingermittelgelenke (PIP). Technik und Ergebnisse.

ABSTRACT

From 1994 to1999, 24 patients were subjected to tenoarthrolysis of the PIP joint by a single surgeon for various reasons. All cases were documented by the surgeon in photographs and the achieved extent of mobility was followed up to at least one year postoperatively. All results were documented in photographs or on video films. The patients did not have conventional arthrolysis following injury of the capsular ligaments of the PIP joint (with the exception of one case), but complex injuries of bone, flexor tendons, diseases, and conditions after infections, some of which had occurred up to seven years previously. Four patients had been subjected to tenoarthrolysis twice, one had undergone tenoarthrolysis even three times. Five joints were fully ankylotic before surgery and had 0 degrees of mobility. All cases were referred from external surgeons. It was not possible to find common denominators for these cases and to include them in a regular study. The sole criterion used for assessment, which has also been used in comparable studies, was preoperative mobility and the postoperative mobility achieved after one year. Preoperative mobility in the PIP joint was on average 27.5 degrees (range, 0 - 60) and could be increased to a mean of 70 degrees (range, 0 to 120) after one year. Thus, an improvement of 42.5 degrees was achieved. As the cases were very different, this study will probably be no more than a case presentation. Nevertheless, based on a careful assessment of video films and photographs and the results achieved in individual cases, conclusions may be drawn regarding technique, surgical planning and prognosis. The author believes that although the data does not suffice to make up a valid study, they still are worthy of presentation.