gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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RegJoint disc spacer use in traumatic trans MCP joint amputation of index finger – Case report

Meeting Abstract

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  • presenting/speaker Tea Jedlovcnik - General Hospital Novo mesto, Novo Mesto, Slovenia
  • Bostjan Lah - General Hospital Novo mesto, Novo Mesto, Slovenia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1542

doi: 10.3205/19ifssh0123, urn:nbn:de:0183-19ifssh01234

Veröffentlicht: 6. Februar 2020

© 2020 Jedlovcnik et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: RegJoint is an implant made of bio absorbable material. Indications for implantation is arthroplasty of small joints in hand and foot, following joint destruction because of rheumatoid arthritis or osteoarthritis. In our case 55-year-old patient was administrated after total trans-MCP joint amputation of the left index finger and loss of articular surface on the head of second metacarpal bone. RegJoint implant was used in primary reconstruction of the second MCP joint.

Methods: We performed replantation of left index finger. X-ray image made preoperatively, indicated in destruction of articular surface of the second metacarpal bone head, which was confirmed during operation. Plan was to keep some mobility in the injured MCP joint after replantation. Methods at our disposal were: interpositional arthroplasty with tendon spacer made of FCR or PL, Swanson finger joint implant and RegJoint disc spacer implant. We decided to use RegJoint implant for arthroplasty of the injured joint, because we wanted to avoid making an additional trauma to the hand, and because we have great results using it in threating rizarthrosis. Postoperatively patient underwent through standard rehabilitation program. Progress was evaluated using VAS, ROM, TAM and QuickDASH score, 2-PD test and aesthetic aspect was observed. First evaluation was made after 12 weeks. 20 weeks after replantation tenolysis was performed due the lack of motion, it was discovered that adhesions between FDP and FDS formed and re-rupture of FDP occurred. Again patient went through rehabilitation program.

Results and Conclusions: Patient was followed throughout rehabilitation. After 12 weeks results were - TAM (5°), QuickDASH (54,5). 20 weeks after the tenolysis was performed. At the end of the rehabilitation program, 26 weeks after, patient was subjectively happy with the result and without pain. TAM (50°), QuickDASH (45,4), VAS (0).

RegJoint can be considered in primary reconstruction of the small joint after hand injury. In this case it is an option in threating some kind of intraarticular fractures as an alternative to arthrodesis.