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A functional treatment method for interphalangeal pyogenic arthritis.

N P Wittels, J M Donley, W E Burkhalter

    The Journal of Hand Surgery
    |November 1, 1984
    PubMed
    Summary
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    This study presents a new surgical approach for pyogenic arthritis, involving ligament resection and early physical therapy. The treatment offers good functional outcomes, potentially avoiding amputation for affected patients.

    Area of Science:

    • Orthopedic Surgery
    • Infectious Disease
    • Rehabilitation Medicine

    Background:

    • Pyogenic arthritis often leads to severe joint damage and functional loss.
    • Amputation was a common outcome for severe cases previously.
    • A novel surgical and rehabilitation strategy is needed to improve outcomes.

    Purpose of the Study:

    • To describe a new treatment plan for pyogenic arthritis.
    • To evaluate the functional results of this treatment method.

    Main Methods:

    • Resection of accessory collateral ligaments via radial and ulnar midaxial incisions.
    • Surgical wound debridement and antibiotic irrigation.
    • Intravenous antibiotics pre- and post-operation.
    • Early physical therapy (within 24 hours) including active range of motion (ROM), dynamic splinting, and hand therapy.

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    Main Results:

    • Forty patients were treated over a 6-year period.
    • Thumb interphalangeal (IP) joints showed significant ROM recovery (4/5 full ROM, 1/5 limited ROM).
    • Distal IP joints had mixed results (1/2 full ROM, 1/2 fusion).
    • Proximal IP joints demonstrated substantial recovery (13/33 full ROM, 13/33 limited ROM).

    Conclusions:

    • This treatment plan provides good functional results for pyogenic arthritis.
    • The described method offers a viable alternative to amputation.
    • Early and comprehensive rehabilitation is crucial for optimal recovery.