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finger/thumb DIP and PIP joint surgery

Discussion in 'Other Joints Forum' started by Josephine, Nov 25, 2017.

  1. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator
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    For those who want to know, a DIP joint is the Distal Inter Phalangeal joint which is the end joint. The middle joint is the PIP joint (Proximal Inter Phalangeal) which lends itself to joint replacement much more easily.

    finger silastic-horz.jpg

    I've many years experience in this kind of surgery and I can tell you without reservation that the DIP joint is never going to be suitable for a joint replacement. Bear in mind that the distal phalangeal bones are minute, about the size of a bone out of the tip of a chicken wing, so working on it to received such an implant would be pretty near impossible. Even a silastic implant would be unlikely to be very successful. So the suggestion of a fusion is by far the best remedy for this situation.
     
  2. melkien

    melkien new member

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    Hello, I cannot seem to see the picture, but after reading this post I wanted to ask. I've had a chronic mallet finger, and in a post from a while ago Josephine you recommended finger fusion because it seems to be the norm for DIP joint injuries.

    What I wanted to ask, so as to be informed and make a decision, is the state of DIP arthroplasty in cases where it actually could be possible? Meaning, I've read some hospitals do offer it but they are very few and I have yet to see a DIP artificial joint online.

    I would really value if you could mention why PIP joints for example are good for joint replacement while DIP joints are not. And in cases where they are used, why would they not be very good? Do they need to be constantly monitored/changed for some reason?

    I would just like to understand the whole situation so as to be informed of what is to come and therefore be able to make a decision.

    Thank you so much for your time!
     
  3. EmEm

    EmEm member

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    Hi @melkien, to get a response from Josephine you need to tag her by putting the @ symbol right in front of her name like I did with yours at the beginning of this reply.
     
  4. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator
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    I did answer this in my other post but will copy it here for you. It's simply a question of possibility!

     
  5. melkien

    melkien new member

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    @Josephine Oh apologies I read incorrectly, I thought you meant that specific DIP joint, not all DIP joints.

    This might be a bit different of a question but do you happen to know how people tend to react to DIP arthrodesis? Meaning, for instance, I would have to have fusion on my little finger DIP joint on my dominant hand, but I would like to know if that would lead to massive loss of grip and/or strength, or if people tend to get used to it pretty easily. Sorry if this goes a bit further than simple surgical/medical questions, but I would really appreciate if you happen to have these kinds of info since it is what is keeping me back from actually doing it.

    Thank you!
     
    Last edited: Jul 28, 2018
  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator
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    Not at all, your question is fine.

    The end result of a DIP fusion is usually that the patient hardly notices it at all.
     
  7. EmEm

    EmEm member

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    @melkien, before I had my wrist fused I wore a brace which had a metal plate that stopped my wrist bending so I had a good idea what it would be like. I also read of people having strapping around their wrist for a few days. You could put some tape or similar around the joint so that you can't bend it then try those activities you are concerned about. For me, the relief from pain was worth the loss of movement.

    For the past 4 weeks I haven't been able to bend the DIP joint of my index finger on my dominant hand following surgery to remove a cyst. I wouldn't want that to be permanent but I have been able to manage by using the other fingers.
     

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