Influence of Index Finger Proximal Interphalangeal Joint Arthrodesis on Precision Pinch Kinematics

• Published in: The Journal of hand surgery (American ed.) Vol. 36; no. 12; pp. 1944 - 1949
• Main Authors: Domalain, Mathieu, Evans, Peter J., Seitz, William H., Li, Zong-Ming
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2011; Elsevier
• Subjects: Arthrodesis; Arthrodesis - methods; Biological and medical sciences; Biomechanical Phenomena; Diseases of the osteoarticular system; finger coordination; Finger Joint - physiology; Finger Joint - surgery; Humans; Medical sciences; Motor Skills - physiology; Orthopedic surgery; Orthopedics; precision pinch; proximal interphalangeal joint; Range of Motion, Articular - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thumb - physiology; Young Adult; Arthrodesis; precision pinch; proximal interphalangeal joint; finger coordination; Proximal; Finger interphalangeal joint; Finger; Pinching; Treatment; Surgery; Orthopedics; Kinematics; Proximal interphalangeal; Index (finger)
• ISSN: 0363-5023; 1531-6564; 1531-6564
• DOI: 10.1016/j.jhsa.2011.09.010

To evaluate the impact of proximal interphalangeal (PIP) joint arthrodesis on the kinematics of precision pinch. Eleven healthy subjects performed index finger–thumb pinch motions under 4 conditions: unrestricted thumb and index finger (CONTROL) and fusion of the PIP joint of the index finger in flexion of 30° (PIP30), 40° (PIP40), and 50° (PIP50). Fusion was simulated with metallic splints. Kinematics of the thumb and index finger were recorded with a motion capture system. Proximal interphalangeal joint fusion at 30°, 40°, and 50° restricted maximal pinch span between the thumb tip and index finger tip by 6%, 10%, and 14%, respectively. At the time of pulp contact, PIP fusion led to an increase in index metacarpophalangeal joint flexion angle for the PIP30 condition and an increase in variability of thumb tip location for the PIP50 condition. Furthermore, the dynamic coordination between joint angles throughout the movement was affected by PIP fusion. This study reports impairment in the kinematics of precision pinch associated with index finger PIP joint fusion. A PIP joint fusion at 40° to 50° leads to a more natural precision pinch posture, but it restricts the aperture and reduces pinch precision. Prognostic I.