Arthroses of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are amongst the most common arthroses of the locomotor system. They are associated with inflammations, limitations to mobility and with pain, as the result of the wear or destruction of cartilage. The causes include hereditary processes (women are about 10 times more affected than men), but in most cases there is no clear causality. As part of the arthrosis, there is swelling and articular wear in the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, with the distal joints also exhibiting typical nodulation. These visible changes are associated with pain and impaired mobility. This visual diagnosis can be confirmed with specific X-ray images.
Treatment of arthroses of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints
In the initial stages, locally acting decongestive drugs or cortisone infiltrations can reduce symptoms. However, the damaged cartilage is generally beyond healing.
In the advanced stages, arthroses can be successfully surgically treated, with different treatments for the PIP and the DIP joints. The proximal interphalangeal joints are important elements in the overall mobility of the finger; for this reason, preference should be for a procedure that maintains mobility. Over the last decades, replacement joints, mainly from silicone, have proven to be successful. The diseased joint is replaced with an artificial one, resulting in pain relief while maintaining a certain degree (about 60%) of mobility. This represents a significant improvement in quality of life combined to a large extent with the absence of symptoms.
Fitting artificial joints in the area of the small distal interphalangeal joints is difficult, because secure fixation is a problem. As pre-operative mobility generally has already been massively restricted, a stiffening of the joint (arthrodesis) in as extended a posture as possible may provide a reasonable result; in terms of functionality, arthrodesis does not represent a significantly greater disability.
Aftercare: Specific hand therapy is employed for the early mobilization of the proximal interphalangeal joints in order to achieve the best possible degree of mobility. For the distal interphalangeal joints, the joint has to be protected and immobilized for 6-8 weeks, until the arthrodesis is completely healed.
After your operation
Most hand surgeries are carried out on an out-patient basis or at least under extended post-operative care. Arrange to be collected from hospital at the agreed time, because you will not be allowed to drive yourself.
At home, cool the joint several times a day by applying a dry ice-pack for about 15 minutes at a time. As a general rule, your hand will be immobilized on a splint, which you can remove at home in line with the care instructions you will have been given.
Medication
For about 2 weeks, you should take 1 x 50 mg tablet of Mephadolor® or Voltaren® 2-3 times a day.
Change of dressing
Dressings are changed 1-2 times a week at your GP's surgery or in our surgery. You can take showers; have your stitches removed after 12-14 days.
Aftercare
Please keep to the stipulated period of immobilization and limited exercise.
Please make sure you keep the check-up appointments agreed with us or other doctors involved in your treatment; recovery after every hand operation is different and requires sensitive and consistent aftercare. be patient, because even 3-5 weeks after surgery, it is still common to experience some symptoms and swelling. At regular intervals, we would like to examine you ourselves in our Centre for Orthopaedic Surgery in order to ensure the best possible recovery process.