Reconstruction of finger function in case of joint defects

Introduction Repair of bone defects in the hand is still a challenge despite advancements in hand surgery and improved surgical techniques. However, the main difficulty still lies in restoring the function of the injured segment when the defect affects functionally significant joints including the proximal interphalangeal and metacarpophalangeal joints of the fingers. Loss of mobility in the joints significantly impairs the physical capabilities of patients and the quality of life. A reconstructive intervention is primarily aimed at restoration of the useful range of motion of the involved finger with minimal risks of postoperative complications.

The objective was to evaluate the possibilities with finger function restoration and the effectiveness of the techniques used to repair defects in the fingers joints based on literature analysis.

Material and methods The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org), Elseiver, Google Scholar (2008 to 2024) and using keywords: finger joint defects, bone loss, intra-articular injuries of the fingers, arthroplasty, small joint replacement, reconstruction of finger joints, joint restoration, metacarpophalangeal joint, proximal interphalangeal joint, bone graft, joint transplantation, joint transfer, microsurgery, vascular bone joint transfer. Sixty articles by foreign authors and 11 publications of Russian researchers were selected for analysis.

Results and discussion With the variety of surgical techniques, there is no universal method for replacing defects in the finger joints. Along with the high rate of postoperative complications, the lack of an optimal method requires careful preoperative planning. Reconstructive interventions should be considered as a method of choice and an alternative to arthrodesis in young, physically active patients. Limited postoperative range of motion in the reconstructed joint is a challenge in the treatment of patients with this pathology. The choice of surgical strategy relies on the patient’s compliance for a complex and lengthy rehabilitation in achievement of a functionally satisfying result.

Conclusion Reconstructive interventions for repair of a bone defect in the joint are practical for increasing the useful range of motion of the involved finger and improving the physical capabilities of the hand.

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