Metacarpophalangeal joint arthroplasty in the setting of trauma

Purpose To report the outcome of pyrocarbon metacarpophalangeal (MCP) joint implants with traumatic nonreconstructible articular cartilage loss. Methods We performed a review of all patients at a single institution who underwent a pyrocarbon MCP joint arthroplasty performed after an acute injury. Of 820 MCP joint arthroplasties performed, 10 were performed in 7 patients for open MCP joint trauma within 24 hours of the initial injury. Six were hemi- and 4 were total arthroplasties. The mean follow-up was 4 years. All injuries were the result of a direct laceration over the MCP joint. Results There were no cases of revision or postoperative infection. Mean total arc of motions for the MCP, proximal interphalangeal, and distal interphalangeal joints were 56° (30° to 70°), 76° (40° to 100°), and 50° (21° to 70°), respectively. Postoperative mean grip, oppositional pinch, and appositional pinch strengths were 28, 9, and 11 kg, respectively. All patients except one reported no or mild pain at the last follow-up. Half of the patients required a tenolysis. Conclusions MCP joint arthroplasty was performed safely in the setting of acute complex open MCP joint trauma. Patients had preservation of adequate MCP joint motion and experienced little pain. MCP arthroplasty should be a consideration in cases of open MCP joint trauma to preserve motion, prevent pain, and avoid fusion. Type of study/level of evidence Therapeutic IV.