Arthroplasty of the proximal interphalangeal joint using costal cartilage grafts

Seven intra-articular fractures in five patients with partial bone loss at the PIP joint were reconstructed using a graft of costal cartilage. In all cases there were total or partial cartilagenous defects of the proximal phalangeal side of the joint. Early treatment of two joints, using only costal cartilage grafts, resulted in bony ankylosis due to necrosis of the grafted cartilage. In five joints the grafted cartilage included osseous portions using the costo-osteochondral junction, leading to an average range of movement of 64 degrees with satisfactory clinical results. The technique is a useful alternative to other forms of arthroplasty or arthrodesis, and can provide satisfactory functional results when there is a partial defect of the head of the proximal phalanx.