Proximal interphalangeal joint arthroplasty with Neuflex® implants: relevance of the volar approach and early rehabilitation.

Proximal interphalangeal joint arthroplasty through a volar approach preserves the extensor apparatus, which allows for early active rehabilitation. Here, we report on the results of 28 silicone implants in patients suffering from rheumatoid arthritis (12 joints) or osteoarthritis (16 joints) with a mean follow-up of 39 months. Pain was reduced significantly after arthroplasty. Range of motion increased significantly by 29° with a mean postoperative value of 58°; the mean extension deficit was reduced from 14° to 5°. There were 18 cases of preoperative ulnar drift with a mean value of 13°, compared with 13 cases postoperatively with a mean value of 7°. Three cases (10%) of implant fracture were noted on the radiology reports. The mean DASH score at follow-up was 35/100. Immediate active mobilization led to significant shortening in recovery time. The improvement in mobility and extension seems to be higher than that obtained with other approaches. Clinodactyly remains problematic no matter the type of arthroplasty.