proximal interphalangeal arthrodesis

Proximal interphalangeal arthrodesis is used for the treatment of hammer toe. Hammer toe refers to the flexion deformity of the proximal interphalangeal joint of the toes. Such malformations can be plasticity, passive can be corrected, can also be fixed, passive can not be corrected. If the deformity is severe, after a long period of time, the metatarsophalangeal joint of the same toe may have an overextension, and the distal interphalangeal joint may also have a flexion or an overextension. Severe fixed hammer toe, due to the compression of the shoe during weight bearing, the hard corns that can cause pain on the dorsal side of the proximal interphalangeal joint, the painful end of the cornea on the temporal side of the toe nail, in the toe humerus Painful convulsions can form under the head. Because of deformities and pain, it can affect wearing shoes and walking. For malleable hammer toes of adolescents or young adults, soft tissue surgery can be used for correction. Taylor and Prris describe the use of extensor tendons displaced to the dorsal aspect of the proximal phalanx to correct the malleable hammer toe. Lapidus introduced the flexor tendon severing of the proximal and distal interphalangeal joints, the incision of the temporal joint capsule, and the suture of the dorsal joint capsule. At the same time, the joint capsule was opened and the extensor tendon was cut off on the dorsal aspect of the metatarsophalangeal joint. The sutured joint capsule is overlapped and sutured to correct the malleable hammer toe. For adult fixed hammer toes, bone and joint surgery is generally required to correct the deformity. Commonly used operations include proximal interphalangeal arthroplasty or arthrodesis, proximal phalangeal proximal hemisection or distal hemisection, proximal phalangeal proximal and distal resection, etc., depending on the deformity of the case application. Treatment of diseases: interphalangeal neuralgia Indication Proximal interphalangeal arthrodesis is suitable for fixed hammer toe deformities, and hard corns with pain on the dorsal side of the proximal interphalangeal joint, affecting adult patients wearing shoes and walking. Preoperative preparation Including skin preparation, osteotome, wire saw, osteophytes and other orthopedic instruments. Surgical procedure 1. Make a transverse diamond-shaped skin incision on the dorsal side of the proximal interphalangeal joint, 5 to 6 mm wide, and remove thickened skin, corns, a small extensor tendon and joint capsule. The skin incisions can be extended proximally and distally, if necessary. 2. The collateral ligaments on both sides of the proximal interphalangeal joint were cut, and then flexed to a 90° position, and the joint capsule and periosteum were peeled off to expose the base of the proximal phalanx and the base of the mid phalanx. Use a bone knife or wire saw to remove the base of the proximal phalanx and the middle phalanx, so that the toes can be passively straightened and the flexion contracture deformity of the proximal interphalangeal joint can be corrected. 3, keep the toe in the straight position, the middle phalanx osteotomy surface and the proximal phalanx osteotomy face close together, with two Kirschner wires for cross fixation, the steel needle to pass through the two phalanx bone cortex, Cut off too many steel needles and leave the needle tail under the skin. 4, suture joint capsule, toe extensor tendon and skin. complication The main complication is uncorrected deformity or unfused joints, which should be prevented during and after surgery.

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