Surgical Approaches to the Proximal Interphalangeal Joint

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Anatomy

Background:

• The proximal interphalangeal (PIP) joint is susceptible to conditions like arthropathy, fractures, dislocations, and malunions.
• While some PIP joint conditions are managed non-surgically, many necessitate open surgical intervention.
• Traditional dorsal approaches to the PIP joint can harm the extensor apparatus, potentially causing extensor lag.

Purpose of the Study:

• To describe and compare different surgical approaches to the proximal interphalangeal (PIP) joint.
• To discuss the advantages and disadvantages of each PIP joint surgical approach.
• To provide guidance on selecting the appropriate PIP joint surgical approach based on the specific procedure.

Main Methods:

• Review of established surgical techniques for PIP joint reconstruction.
• Comparative analysis of dorsal, volar, and lateral surgical approaches.
• Discussion of surgical indications and contraindications for each approach.

Main Results:

• Dorsal approaches, while traditional, pose risks to the extensor mechanism.
• Volar and lateral approaches offer alternative access to the PIP joint with potentially fewer complications.
• Specific procedures like arthroplasty, arthrodesis, open reduction internal fixation, and osteotomy may favor different approaches.

Conclusions:

• The choice of surgical approach for PIP joint pathology is critical and depends on the specific condition and planned intervention.
• Volar and lateral approaches are increasingly explored to mitigate the risks associated with dorsal PIP joint surgery.
• Understanding the nuances of each approach allows for tailored treatment strategies and improved functional recovery of the PIP joint.