[Endoprostheses of the hand]

In 1890, the German surgeon T. Gluck was the first to implant an ivory arthroplasty into a wrist which was being destroyed by tuberculosis. The finger joints were first replaced with endoprostheses in 1940 by Burman. Indications for the procedure are degenerative, posttraumatic or arthritis related destruction of the joints of the hand.Nowadays, several more or less comparable prosthetic designs are available. The replacement of single bones of the wrist has not been of lasting success. Occasionally, an indication for arthroplasty of the trapezium-metacarpal joint of the thumb may exist. The metacarpophalangeal joint of the thumb should, in our experience, be fused when the need arises. Up until the present, the silastic spacer of Swanson for the metacarpophalangeal and proximal interphalangeal joints has not shown any substantial development, although a variety of designs have been introduced. Questions related to the complicated biomechanics of these articulations in combination with problems concerning the material to be used, intraosseous fixation, the articulation of the prosthesis components and the design of the stems have not yet been solved convincingly. The Swanson spacers in mid- to long-term follow-ups show little active range of motion, although the subjective patient satisfaction is very high and the potential for removal at its best. We do not see an indication for arthroplasty in the distal interphalangeal finger joints.