Soft tissue interpositional arthroplasty as a treatment of proximal interphalangeal joint arthritis in resource-limited health care facility: A case report

INTRODUCTION: Treatment of choice for posttraumatic arthritis in proximal interphalangeal (PIP) joints has remained a controversial subject. There is a lack of consensus regarding the optimal approach and treatment options for PIP joint arthritis. In this study, we report our experience in management of PIP joint arthritis using soft-tissue interpositional arthroplasty. CASE PRESENTATION: A 12-year-old female, right-handed, complains of stiffness on the left ring finger. There was a flexion deformity accompanied by limitation on both active and passive flexion-extension range of motion (ROM) of the PIP joint. Soft tissue interpositional arthroplasty was then performed using middle phalanx periosteum as interpositional material. Postoperative follow-up showed improvement in both active and passive ROM of PIP joint, improvement in joint function, and a good pain relief. Overall, the patient was satisfied with the outcomes of the procedure. CLINICAL DISCUSSION: Arthrodesis, implant arthroplasty, and interpositional arthroplasty are the treatments of choice for stiff fingers that are caused by bone problems. In this study, we report a case of PIP joint arthritis treated with interpositional arthroplasty. It was able to provide ROM improvement and good functional results. Periosteum is used as an interposition material because of its in-situ nature thereby reducing donor site related morbidity and postoperative complications. In addition, the use of the periosteum makes this procedure relatively inexpensive and makes it a suitable treatment of choice in limited resources areas. CONCLUSION: Soft tissue interpositional arthroplasty shows promising results as a treatment option for arthritis of PIP joint, especially in limited resource areas.