[Pedicled joint transfers in the fingers].

OBJECTIVES

We report a retrospective series of 27 cases of composite island homodigital distal interphalangeal joint to replace proximal destroyed interphalangeal joint. Results of our series are compared with other procedures available in order to specify the place of pedicled articular transfers mainly for the proximal interphalangeal joint which is recognized as the most important joint in the finger.

METHODS

The series included 27 cases of destroyed proximal interphalangeal joints with preservation of the distal interphalangeal joint, the flexor tendon and vascular pedicles. The mean age was 32 years, 26 male, all manual workers. All fingers were concerned mainly the third (13 cases) and the fourth (10 cases).

RESULTS

No vascular failure. Pain quotation improved from 7 preoperatively to 2 postoperatively. Average flexion-extension motion arc was 43°. The grip strength was 54% compared to the opposite side. The average time off work was 7 months. Complications were few, all of them due to technical imperfections underlining the difficulty of this procedure. This transfer deserves his use due to the better mobility he gives compared to the other techniques available.

CONCLUSIONS

Reconstruction of important articular loss of substance in a digit remains an unsolved problem, especially for the proximal interphalangeal joint representing the anatomical and functional center of the digit. However, in certain good indications, especially in emergency it deserves to be used.