Finger Joint Replacement: Key Questions Answered

Questions about artificial finger joints?

A month ago, I injured the joint of my right hand's ring finger in an accident.
The doctor diagnosed it as a fracture causing joint surface damage.
I was informed that in order to regain normal movement and bending, I would need to undergo joint replacement surgery.
I would like to ask:
1.
Will I need to use steel pins for fixation during the finger joint replacement surgery?
2.
Are there options for self-funded artificial joints made of better materials?
3.
How durable and load-bearing are the finger artificial joints available on the market?

scoot, 30~39 year old female. Ask Date: 2009/12/20

Dr. Chen Xingyuan reply Orthopedics

Dear Reader,
Finger joint replacement is not common and has only been sporadically reported at academic conferences.
This is related to the specific patient population suitable for the procedure and the suboptimal postoperative outcomes.
Previous reports have indicated that while the short-term results of finger joint prostheses may be promising, the long-term prognosis can be worse than that of non-surgical management.
If the condition only affects appearance, it may not warrant intervention; however, if pain is present, it is advisable to first attempt rehabilitation therapy to alleviate symptoms.
The decision to proceed with joint replacement should consider not only the damage to the joint surface but also the condition of the surrounding soft tissues, such as tendons, ligaments, and skin.
Otherwise, functional recovery post-surgery may not be satisfactory.
Currently, this procedure is primarily used for patients with rheumatoid arthritis, and while cobalt-chromium finger joints are available, it is unclear whether they have been imported or passed clinical trials in Taiwan.
Additionally, this procedure is not covered by national health insurance and would require out-of-pocket expenses.
There is still a lack of long-term follow-up reports on the durability and load-bearing capacity of finger joint prostheses.
Generally, there is no need for steel pins for fixation after finger joint replacement surgery.
I recommend consulting with a hand surgeon at a medical center to assess the suitability for finger joint replacement surgery.
Wishing you safety and success!
Sincerely,
Dr.
Chen

Reply Date: 2009/12/20

More Info

Finger joint replacement surgery is a significant procedure that can greatly improve function and quality of life for individuals suffering from joint damage due to injury or degenerative conditions. In your case, where a fracture has led to joint surface damage in the right hand's ring finger, understanding the implications of this surgery is crucial. Let’s address your questions one by one.

1. Will finger joint replacement surgery require additional fixation with pins or screws?
In many cases, the surgical procedure for finger joint replacement may involve the use of pins, screws, or other fixation devices to stabilize the joint during the healing process. This is particularly true if there is significant bone loss or instability in the joint. The fixation devices help ensure that the new joint is properly aligned and can heal correctly. However, the specific approach can vary based on the surgeon's assessment of the injury and the type of prosthetic joint being used. It's essential to discuss this with your orthopedic surgeon, who can provide detailed information tailored to your specific situation.

2. Are there options for self-paying for higher-quality materials for the artificial joint?
Yes, there are often options for patients who wish to upgrade to higher-quality materials for their artificial joints. Many orthopedic surgeons offer different types of prosthetic joints made from various materials, such as titanium, cobalt-chromium alloys, or even advanced polymers. These materials can offer better durability, biocompatibility, and sometimes improved functionality. However, the availability of these options may depend on the specific healthcare facility and the surgeon's preferences. It's advisable to have a candid conversation with your surgeon about the available options, their costs, and the potential benefits of choosing a higher-quality prosthetic joint.

3. What is the durability and load-bearing capacity of finger joint replacements available on the market?
The durability and load-bearing capacity of finger joint replacements can vary significantly based on the materials used and the design of the prosthetic joint. Generally, modern finger joint replacements are designed to withstand the normal forces exerted during daily activities. Most prosthetic joints can endure typical loads encountered in hand function, such as gripping and pinching. However, the longevity of the joint can be influenced by factors such as the patient's activity level, the presence of any underlying conditions (like arthritis), and how well the joint is rehabilitated post-surgery. Studies suggest that many finger joint replacements can last for several years, with some patients experiencing good function for over a decade. Nevertheless, it is essential to follow post-operative rehabilitation protocols to maximize the longevity and functionality of the replacement joint.

In addition to addressing your specific questions, it is important to consider the overall rehabilitation process following finger joint replacement surgery. Physical therapy plays a crucial role in regaining strength, flexibility, and function in the affected finger. Your surgeon will likely recommend a tailored rehabilitation program that may include exercises to improve range of motion, strength training, and techniques to help you adapt to the new joint.

In conclusion, finger joint replacement surgery can significantly enhance your ability to perform daily activities and improve your quality of life. It is essential to have thorough discussions with your orthopedic surgeon regarding the specifics of your case, including the need for additional fixation, options for higher-quality prosthetics, and the expected durability of the replacement joint. With proper surgical intervention and rehabilitation, many patients can return to their desired level of activity and enjoy improved hand function.

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