Chronic dislocations of the proximal interphalangeal (PIP) joint pose a significant treatment challenge. Chronically dislocated PIP joints can experience several changes to the articular cartilage including pressure necrosis, degeneration, and the development of secondary incongruence. Moreover, chronic dislocation allows the edema and hemorrhage from soft tissue trauma to develop into collateral ligament fibrosis and inelastic scar formation. Similarly, chronic dislocations associated with a fracture at the base of the middle phalanx can also experience changes in the form of joint incongruency, bony resorption, or malunion formation. Subsequently, these cumulative joint changes prohibit standard open reduction of the PIP joint and can cause significant loss of motion thereby demanding a different approach to restore motion and minimize pain. We propose the use of silicone arthroplasty in the management of chronic dislocations of the PIP joint.
*Temple Hand Center, Department of Orthopaedic Surgery, Temple University Hospital
†Rothman Institute, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA
Address correspondence and reprint requests to Asif M. Ilyas, MD, Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA 19107. e-mail: firstname.lastname@example.org.
Conflicts of Interest: The authors report no conficts of interest.