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Online ISSN 1827-1707
U.O. di Ortopedia e Traumatologia Ospedale “S. Cuore di Gesù”, Gallipoli Lecce, Italia
Aim. Many prosthetic implants have been designed for the replacement of the joint’s hand. Although studies of these implants have shown relief of pain, they have generally demonstrated a poor range of motion, bone loss, as well as failure, fracture, and dislocation of the implant. Pyrolytic carbon is biologically and biomechanically compatible, wear resistant and durable material for many different kinds of artroplasty and spacer to implant in the wrist and hand for post-traumatic or degenerative arthrosis. The prostheses pyrocarbon are anatomical, non constrained, with variable articular fulcrum.
Methods. From October 2004 to December 2008, 12 pyrolytic carbon implants were inserted in 12 patients with trapezio-metacarpal joint’s arthrosis or finger’s fracture.
Results. All the patients are satisfying, especially in regards the daily activities and significant pain reduction: ROM was a good in the fingers and a good strength in the thumb was registered.
Conclusion. This study demonstrates that pyrolytic carbon implant give good results functionally and on radiographs. Low-profile, anatomically designed implants limit the amount of bone removed and preserve the integrity of the collateral ligaments. A metacarpophalangeal joint implant with an elliptical metacarpal head and a nonfixed center of rotation can enhance stability in flexion through greater articular contact. A proximal interphalangeal joint implant that preserves the collateral ligaments also can achieve improved stability. The spacer for the thumb preserved the column and the distance between the base of the first metacarpal bone and the trapezio remained unchanged during the follow-up. Component loosening is not an early complication with these recent designs, and arc of motion is satisfactory.