Indications Metacarpophalangeal (MCP) joint stiffness can usually be prevented or corrected with nonoperative management, such as edema control, splinting, and early joint mobilization. About 90% of patients with MCP contractures are successfully treated nonoperatively. MCP capsulotomy is indicated in motivated…
Indications Proximal interphalangeal (PIP) joint capsulotomy is indicated for patients with decreased range of motion (ROM) and functional limitations who have failed nonoperative management (active joint mobilization, dynamic and/or static splinting, and passive stretching). Patients must understand that recurrence is…
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Indications Wrist denervation is indicated in patients with chronic pain but preserved motion after exhausting nonoperative treatments. Patients are candidates for denervation if they have pain from primary degenerative or inflammatory arthritis, osteonecrosis (Kienböck or Preiser disease), or traumatic conditions,…
Indications Total wrist fusion is indicated in patients with pain or instability after failure of nonoperative management and motion-preserving procedures. Wrist fusion is preferred when multiple joints (i.e., the radiocarpal and midcarpal joints) are involved. If disease is isolated to…
Indications Total wrist arthroplasty (TWA) is indicated in low-demand patients with severe wrist pain who require some motion. Potential candidates include patients with osteoarthritis (OA), posttraumatic arthritis, and sometimes rheumatoid arthritis (RA). Although new implant designs show promise, TWA is…
Indications Matched hemiresection ulnar arthroplasty is indicated in patients with distal radioulnar joint (DRUJ) pain from posttraumatic arthritis, osteoarthritis (OA), or inflammatory arthritis with an intact triangular fibrocartilaginous complex (TFCC). The premise of hemiresection arthroplasty is that the DRUJ articulation…
Indications The Sauvé-Kapandji procedure consists of fusion of the distal radioulnar joint (DRUJ) and resection of a short segment of ulna proximal to the joint to preserve forearm motion. It eliminates the painful articulation between the ulna and sigmoid notch…
Indications The goal of surgical treatment of distal radioulnar joint (DRUJ) arthritis is to eliminate the articulation between the distal ulna and the sigmoid notch. Options include distal ulna resection (Darrach procedure) or hemi-resection (Bowers procedure; see Chapter 51 ),…
Indications Carpometacarpal (CMC) joint arthroplasty with trapeziectomy with or without ligament reconstruction provides predictable pain relief for most patients. Revision CMC arthroplasty is indicated in patients with persistent or recurrent basilar thumb pain or instability who are at least 1…