Metacarpophalangeal Joint (MPJ) Arthroplasty

Rheumatoid arthritis frequently leads to destructive changes of the metacarpophalangeal joints which can impair hand function. Replacement of these joints can lead to better finger position and function.

X-Ray reveals extensive arthritic destruction and volar subluxation of the proximal phalanges.







Another view revealing the destructive joint changes as a result of Rheumatoid Arthritis.







Preoperative hand demonstrating volar subluxation and ulnar drift of the fingers at the metacarpophalangeal joint level.







Lateral preoperative view revealing gross deformity with prominent metacarpal heads and synovitis of the MPJ’s and dorsal wrist. Resulting in poor flexion.







Intra-operative view after the synovectomies of the MPJ’s and dorsal wrist was performed along with metacqrpophalangeal joints replacement, extensor tendon realignment and crossed intrinsic transfers performed to prevent recurrent ulnar drift.







Early post-operative view with full extension and correction of the volar subluxation and ulnar drift of the metacarpo-phalangeal joints.







Good Flexion is evident in this post-operative photograph.