Thumb CMC Arthritis: Fellowship Virtual Debate Series
Drs Buterbaugh, Putnam, Fitzpartick, and Stepan debate the merits of LRTI, Suture button suspension arthroplasty, Suture suspension arthroplasty with or without an implant, and arthrodesis for management of thumb CMC arthritis
Proximal interphalangeal (PIP) joint arthroplasty can provide pain-free and functional restoration to the mobility and stability of the joint. In cases with less than 30 degrees of deviation in the coronal plane, silicone implant interposition arthroplasty canbe used. While a dorsal approach is used most frequently, post-operative immobilization of varying amounts of time are required to allow for healing of the extensor mechanism.
Although technically more demanding, the volar approach allows for immediate post-operative rehabilitation. In this case, a 65-year-old patient presented with painful osteoarthritis of the PIP joint of the right index finger, resulting in weakness of pinch and loss of motion. She has had a previous DIP arthrodesis. Plain radiographs revealed coronal deformity without sagittal malalignment, and 10-55 degrees of passive motion. A volar approach was recommended. This video describes the successful reconstruction
of the index PIP joint using silicone implant arthroplasty from a volar approach.
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Drs. Blood, Freniere and Evans debate the merits of in situ cubital tunnel release, anterior transposition, and supercharge AIN to ulnar motor nerve transfer, followed by a discussion of these procedures
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