Pins and Rubber Band Traction System Combined with Internal Fixation for Intra-articular Fractures of the Proximal Interphalangeal Joints.

Background: Intra-articular fractures of the proximal interphalangeal joint (PIPJ) can result in poor outcomes if inadequately treated. Dynamic external fixation and internal fixation with plates and/or screws are two treatment options. The role of combining these two methods is unclear. The aim of this study is to determine the outcomes of patients with intra-articular fractures of the PIPJ treated with a combination of dynamic external fixation with a plate and/or screws. Methods: A retrospective review was conducted on 18 consecutive cases of intra-articular fractures of the PIPJ treated with pins and rubber band traction system (PRTS) combined with dorsal internal fixation with plates and/or screws. The patients' average age was 51 years (range: 20-81 years). The fracture patterns were volar-type (n = 2), dorsal-type (n = 4) and pilon-type (n = 12). Data with regard to time to surgery, interphalangeal joint range of motion, grip strength, VAS for pain, Quick DASH score, complications, duration of follow-up and return to work were collected. Results: The levels of articular involvement were stable (n = 1), tenuous (n = 5) and unstable (n = 12). The average time to surgery was 9 days, and the average follow-up period was 15 months. The fracture was fixed with a dorsal plate and screws in 10 patients and with only screws in eight patients. All patients had PRTS. All patients returned to their original occupation and the fractures united in good alignment. The average grip strength was 86% of that of the unaffected side. The average active PIPJ motion was 85° (range: 50°-106°), and the average active distal interphalangeal joint (DIPJ) motion was 48° (range: 10°-90°). Conclusions: Our results show that a combination of PRTS and open reduction and fixation with plate and/or screws achieved a good range of motion and articular reduction. Level of Evidence: Level IV (Therapeutic).

Entrapment of the Volar Plate in the Retrocondylar Space of the Proximal Interphalangeal Joint Necessitating Open Reduction and Internal Fixation: A Case Report.

Introduction: Fracture-dislocations of the proximal interphalangeal joint (PIPJ) can have a significant impact on digital motion and hand function if inappropriately treated. While these injuries are commonly encountered, they can be quite challenging to manage. It is critical to ensure a concentric reduction and early motion when treating these injuries. Case Report: A 17-year-old woman sustained a fracture-dislocation of the PIPJ of the left small finger. Despite a concentric closed reduction, she had pain and a mechanical block to PIPJ motion. Advanced imaging revealed volar plate entrapment in the retrocondylar space. She was treated with open reduction and direct volar plate repair. Postoperatively, the patient had an excellent outcome with no complications. Conclusion: Our case highlights the importance of both performing an anesthetized examination and investigating the etiology of any limitations to motion even if there is an initial acceptable closed reduction.

OpenHands: An Open-Source Statistical Shape Model of the Finger Bones.

This paper presents statistical shape models of the four fingers of the hand, with an emphasis on anatomic analysis of the proximal and distal interphalangeal joints. A multi-body statistical shape modelling pipeline was implemented on an exemplar training dataset of computed tomography (CT) scans of 10 right hands (5F:5M, 27-37 years, free from disease or injury) imaged at 0.3 mm resolution, segmented, meshed and aligned. Model generated included pose neutralisation to remove joint angle variation during imaging. Repositioning was successful; no joint flexion variation was observed in the resulting model. The first principal component (PC) of morphological variation represented phalanx size in all fingers. Subsequent PCs showed variation in position along the palmar-dorsal axis, and bone breadth: length ratio. Finally, the models were interrogated to provide gross measures of bone lengths and joint spaces. These models have been published for open use to support wider community efforts in hand biomechanical analysis, providing bony anatomy descriptions whilst preserving the security of the underlying imaging data and privacy of the participants. The model describes a small, homogeneous population, and assumptions cannot be made about how it represents individuals outside the training dataset. However, it supplements anthropometric datasets with additional shape information, and may be useful for investigating factors such as joint morphology and design of hand-interfacing devices and products. The model has been shared as an open-source repository ( https://github.com/abel-research/OpenHands ), and we encourage the community to use and contribute to it.

Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries.

Background: Complex proximal interphalangeal joint (PIPJ) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIPJ fractures treated with a hand-specific external fixation device. Methods: Twenty-five fingers in 25 patients were treated with the DigiFix external fixator device for treatment of a PIPJ dorsal fracture dislocation (n = 16) or pilon fracture (n = 9). There were 16 males and 9 females with a mean age of 40 years (range: 14-75 years) at the time of injury. The median time from injury to surgery was 10 days (interquartile range [IQR]: 5; range: 3-49). Chart and radiographic data were reviewed retrospectively. Results: The average duration of external fixation was 41 days (range: 26-62 days). At a mean follow-up of 28 weeks (range: 12-105 weeks), the mean PIPJ flexion was 82 (range: 30-105 degrees), extension was -10° (range: -30 to 0 degrees), and flexion/extension arc of motion was 72 degrees (range: 30-95 degrees). Final mean Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 21.5 (range: 0-65.8). There were zero major complications and six (24%) minor complications, including superficial cellulitis (4) and stiffness (2). Conclusion: Dynamic external fixation for the treatment of complex PIPJ injuries allows for early range of motion and leads to favorable outcomes. This hand-specific external fixator has a reproducible technique which results in predictable and reliable PIPJ distraction.

Revolutionizing PIP joint fracture treatment: A case of surgical precision and rapid recovery.

INTRODUCTION: Proximal interphalangeal joint (PIPj) fractures are a common yet challenging injury, particularly in athletes. This case study explores innovative surgical techniques combined with targeted rehabilitation to optimize recovery and functionality. CASE PRESENTATION: A 20-year-old male soccer goalkeeper sustained a severe Proximal Interphalangeal Joint fracture-dislocation of the third finger during a game. He was treated using the wide awake local anesthesia no tourniquet (WALANT) technique and a Medartis TriLock plate, originally designed for the proximal phalanx but adapted for use on the middle phalanx. CLINICAL DISCUSSION: Immediate postoperative mobilization was facilitated by the WALANT technique, enhancing pain management and functional recovery. The adaptation of the TriLock plate, typically not used in this context, proved crucial for stabilizing the complex fracture. Follow-up included regular physiotherapy, focusing on mobility exercises and strength training, which were instrumental in the patient's quick return to sport. CONCLUSIONS: This case underscores the effectiveness of combining innovative surgical adaptations with early rehabilitation in treating complex hand injuries. Such approaches can lead to successful outcomes, significantly improving recovery times and functional results in athletic populations. This strategy may set a precedent for future treatment protocols in sports-related hand injuries.

A Hemi-Hemi-Hamate Osteochondral Graft: A Modified Hemi-Hamate Technique for a Unicondylar Defect.

Articular comminuted fracture dislocations of the base of the middle phalanx represent a major challenge for the surgeon. The treatment goal is a nonpainful, stable, and functional proximal interphalangeal joint, which is achieved through concentric joint reduction and restoration of joint stability. Fracture pattern rarely results in sagittal bone loss involving the entire ulnar or radial pilon of the base of the second phalanx. In these cases, the choice of treatment can be particularly challenging as the loss of a pillar of the articular base causes angular deviation at the joint level, thus causing the loss of finger joint flexion and overlap of the adjacent finger. We present a novel nonvascularized osteochondral graft, which we named hemi-hemi-hamate osteochondral graft, a modified version of the traditional hemi-hamate arthroplasty, that is suitable for the reconstruction of bone loss involving the whole anteroposterior hemiarticular surface of the base of the P2.

A Review on Volar Fracture-Dislocations of the Proximal Interphalangeal Joint.

Volar fracture-dislocations of the proximal interphalangeal joint are rare injuries caused by an axial force on a flexed digit resulting in an avulsion fracture of the dorsal lip of the middle phalanx with volar dislocation of the joint. This volar subtype is analogous to the more common dorsal subtype with a mirror image fracture on the dorsal lip of the middle phalanx. The main significance in this type of injury lies in the disruption of the extensor mechanism at the central slip. The goals of treatment, apart from restoring a congruent and stable joint, is to restore the extensor mechanism to prevent a boutonnière deformity. In this article, we summarise the current literature and discuss the principles for treatment of this uncommon injury. Level of Evidence: Level V (Therapeutic).

Salvage of failed proximal interphalangeal arthroplasty with vascularised toe joint transfer: Report of two cases.

Failed implants of the proximal interphalangeal joint may result in bone and soft tissue deficits and joint instability with limited reliable options for reconstruction besides an arthrodesis procedure. The purpose of this report is to illustrate the use of vascularized second toe joint for salvage of failed, multi-operated proximal interphalangeal joint in two active patients. Pre-existing scars are used to define the approach and choice of donor site. Flow through anastomosis was performed on the finger digital artery. At final follow-up, the transplanted joints achieved 80-90 degrees of motion and the patients were able to return to their desired level of activities. The procedure is a good alternative for the fit patient wanting to achieve a stable finger with preservation of motion in catastrophic failure of prosthetic proximal interphalangeal joint arthroplasty.

Stabilization of the hypoplastic thumb type Blauth IIIB using a non-vascularized proximal interphalangeal joint from the toe as an alternative reconstruction when pollicization is not accepted: Description of the surgical technique.

BACKGROUND: A Blauth IIIB hypoplastic thumb is a significant functional and cosmetic problem for the developing hand in children. The gold standard in treatment is amputation and index pollicization. Despite the good functional results, some parents do not consent to the operation, mainly for cosmetic reasons. OBJECTIVES: The aim is to present a detailed description and features of the technique used in our department for stabilization of a hypoplastic thumb type Blauth IIIB with a non-vascularized proximal interphalangeal joint from the toe. This is the first description of this surgery for this kind of congenital defect, together with the largest group of patients analyzed compared to alternative techniques described in the literature. MATERIAL AND METHODS: Sixteen patients were included in the analysis. The mean age was 3 years (standard deviation (SD) ±2). In most cases, it was a unilateral and isolated defect. We described the surgical technique and postoperative management in detail and assessed intraoperative factors such as donor selection, operative time, technical problems, stabilization time, complication rate, and reoperations. Appropriate statistics were performed. RESULTS: Most often, the graft was taken from the 3rd toe. The average operation time was 59 ±17.5 min. No technical problems were found during the surgery. The Kirschner wire was removed after an average of 6.5 weeks. The complication rate was 25%, which included the destabilization of Kirschner wires or graft non-union, but it decreased to 6% after reoperation. Five patients underwent tendon transfers. CONCLUSIONS: The presented technique is based on principles such as vascularized metatarsophalangeal joint transplants. It may be an option for stabilizing a hypoplastic thumb if parents do not consent to pollicization. Having microsurgical skills is unnecessary. The operation and anesthesia times are significantly shorter, resulting in less burden on the child's body. The study will continue assessing long-term postoperative functions and the comparison to pollicization.

Acute calcific periarthritis in a proximal interphalangeal joint of the hand after acute trauma: a rare case.

Acute calcific periarthritis (ACP) in the interphalangeal joints of the hand is rare, with less than 100 cases reported. A rare case of ACP in a proximal interphalangeal (PIP) joint of the hand, in a young black woman, after acute trauma, is presented. She experienced severe pain and limited range of motion, and was medicated with an oral corticoid, which was followed by a rapid resolution of the symptoms. At six months, there were no signs of clinical or radiographic recurrence. Recognition of ACP allows for avoiding unnecessary treatments. In this case, treatment with corticoids might have played a role in a faster recovery.

La periartritis calcificada aguda (PCA) en las articulaciones interfalángicas de la mano es rara, con menos de 100 casos reportados. Se presenta un caso raro de PCA en una articulación interfalángica proximal (IFP) de la mano, en una mujer joven de raza negra, después de un traumatismo agudo. Experimentó dolor intenso y rango de movimiento limitado, y fue medicada con un corticoide oral, lo que fue seguido por una rápida resolución de los síntomas. A los seis meses no hubo signos de recurrencia clínica ni radiológica. El reconocimiento de PCA permite evitar tratamientos innecesarios. En este caso, el tratamiento con corticoides podría haber contribuido a una recuperación más rápida.

Reconstructive Surgical Intervention for Malunited Distal End Radius and Ulna Fracture: A Case Report Demonstrating Improved Patient Outcomes.

This case report explores the efficacy of reconstructive surgical intervention in addressing malunited fractures of the distal end of the radius and ulna. The study presents a detailed analysis of a specific case, highlighting the surgical techniques employed and their impact on patient outcomes. The report emphasizes the importance of precision in addressing malunited fractures and showcases how the intervention led to improved patient outcomes. By documenting this case, the study contributes valuable insights into the field of orthopedic surgery, providing a basis for further research and enhancing the understanding of optimal approaches to managing such complex fractures.

Management of stable proximal interphalangeal joint volar plate injuries with figure-of-8 orthoses: A parallel-group randomized controlled trial.

BACKGROUND: Volar plate injuries of the proximal interphalangeal (PIP) finger joint are common. Conservative treatment involves orthoses to limit hyperextension at the PIP joint yet allow movement of the joints to prevent joint stiffness and deformity. Custom-made dorsal blocking orthoses are recommended treatments. Previous research also supports the use of a figure-of-8 orthosis, although the comparative effectiveness of these orthoses is not currently known. PURPOSE: This study aimed to compare the figure-of-8 orthosis and dorsal blocking orthosis for changes in the range of movement, pain, and function following stable volar plate PIP joint injuries and to compare the number of hand therapy appointments required. STUDY DESIGN: A parallel-group pilot randomized controlled trial. This trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: CTRN12619000449134). METHODS: Participants aged 13-65 years were recruited from an outpatient hand therapy service and randomly assigned to experimental or control groups. The experimental group of 20 participants received a custom-made thermoplastic figure-of-8 orthosis limiting the extension to 15-20 degrees. The control group of 22 participants had a dorsal blocking orthosis, which was serially extended by 10 degrees weekly starting at 30 degrees flexion. Participants were blinded to their group allocation. Outcome measures included range of movement, edema, pain, function, and number of hand therapy appointments. Data collection was completed by the treating therapist who was not blinded to group assignment. Data analysis included a series of mixed-model analyses of variance to examine changes over time. RESULTS: Forty-two participants were recruited and had their data analyzed. No significant between-group differences were observed for DIP flexion, PIP flexion, pain, and function from baseline to follow-up. Both groups exhibited significant improvements in these outcomes over time (p < 0.001); effect sizes ranged from small to large (0.28-0.79). On average, the intervention group required 4 (±1.5) appointments compared to 6 (±1.5) in the control group over the same period representing a significant difference (p < 0.001). CONCLUSIONS: Both dorsal blocking and figure-of-8 orthoses provide similar outcomes. The use of a figure-of-8 orthosis, or a dorsal block orthosis fabricated in maximal comfortable extension depending on severity, could reduce the number of appointments and increase convenience for patients.

Extension block pinning for chronic volar base fractures of the middle phalanges.

Due to the simplicity, low cost and benefit of avoiding long-term joint immobilization, extension block pinning could be a suitable option for treating the volar base fractures of the middle phalanges. The aim of the present study was to evaluate the outcomes of using extension block pinning in chronic volar base fractures of the middle phalanges. In total, 26 patients with chronic closed volar base fractures of the middle phalanges were included our study. The mean age was 37 years (SD 11.59), and the mean follow-up time was 35 months (SD 19.41). The mean active range of motion (ROM) after surgery was 93° (SD 12.9). There was a negative correlation between the age and the ROM of the injured proximal interphalangeal joint after surgery. ROM did not correlate with the articular surface involvement or the interval between injury and surgery. We obtained a satisfactory result from extension block pinning for volar base fractures of the proximal interphalangeal joint in patients with chronic injuries.Level of evidence: IV.

Management of Pediatric Volar Plate Avulsion Fractures of the Proximal Interphalangeal Joint: A Systematic Review.

BACKGROUND: Sudden, forced hyperextension injuries to the proximal interphalangeal joint leading to volar plate avulsion fractures are common hand injuries in children. Suboptimal management of these fractures can lead to the development of long-term complications such as stiffness and flexion contracture. METHODS: MEDLINE (PubMed), Scopus, Embase, Google Scholar, and Cochrane CENTRAL databases were systematically searched, and additional studies were found through reference of articles up to June 15, 2023. Identified articles were assessed using predetermined inclusion/exclusion criteria. RESULTS: Twenty-five articles were included, involving 268 patients with ages from 3 to 17 years. Fractures with less than 30% joint involvement, classified as Eaton type I or II, or designated as "Stable" in the Keifhaber-Stern classification, were treated through nonsurgical means. Surgical interventions, encompassing open reduction and internal fixation, were reserved for fractures with more than 30% joint involvement and/or meeting criteria such as Eaton type IIIa or IIIb and Keifhaber-Stern "Tenuous" or "Unstable." Positive outcomes were seen in 99.5% of patients receiving nonsurgical treatment, compared with 85.7% in the surgical cohort. CONCLUSIONS: The literature demonstrated positive outcomes for fractures presenting with less than 30% joint involvement that were managed nonsurgically. In fractures with more than 30% joint involvement, surgical interventions yielded positive results. To further substantiate these findings, larger prospective studies with uniform measures are needed to validate the results of this study.

Reconstruction of Delayed Proximal Interphalangeal Joint Fracture-Dislocation Using Hemi-Hamate Arthroplasty: A Case Report.

This case report aims to delineate the clinical outcomes and technical considerations of hemi-hamate arthroplasty in the reconstruction of a delayed proximal interphalangeal (PIP) joint fracture-dislocation. It underscores the procedure's viability as a reconstructive option for complex finger injuries with delayed presentation. A 23-year-old male presented six weeks post-injury with a PIP joint fracture-dislocation of the left index finger. Traditional management options were limited due to the delayed presentation and the nature of the injury. A surgical intervention was performed using an autologous osteochondral hemi-hamate graft to reconstruct the articular surface. Herein, we describe the detailed surgical steps, postoperative care, and rehabilitation protocols. Over a five-month follow-up period, the patient demonstrated significant functional improvement. The range of motion in the PIP joint increased substantially, with a notable reduction in pain levels. Radiographic assessments showed successful graft incorporation and joint alignment. The patient reported satisfaction with the aesthetic and functional outcome, highlighting an enhanced quality of life post-surgery. Hemi-hamate arthroplasty emerges as a favorable surgical option for delayed PIP joint fracture-dislocations, offering improved articular congruity, joint stability, and functional outcomes. This case contributes to the growing body of evidence supporting the procedure's effectiveness and underscores the importance of considering innovative approaches in complex hand injuries.

Biomechanical Analysis of Headless Compression Screw Versus Tension Band Wiring for Proximal Interphalangeal Joint Arthrodesis.

PURPOSE: Proximal interphalangeal (PIP) joint arthrodesis is a procedure employed to address arthritis, instability, and deformity. Multiple fixation methods are available to maintain stability across the arthrodesis interval, including headless compression screws (HCSs), tension band wiring (TBW), plating, and Kirschner wire constructs. The purpose of this study was to compare the biomechanical properties of the HCS and TBW techniques. METHODS: Thirty-two nonthumb digits from the paired upper limbs of four fresh frozen cadavers were divided into pairs, matching contralateral digits from the same specimen. One PIP joint of each pair was fused with an antegrade 3.5 mm HCS, and the second was fused with TBW using 0.035 in. Kirschner wires with 24-gauge dental wire. Each construct was then stressed to 10 N in the radial deviation, ulnar deviation, flexion, and extension planes, and stiffness (N/mm) was calculated. The fingers were stressed to failure in extension with the ultimate load and mode of failure recorded. RESULTS: When stressed in extension, the HCS construct had a significantly greater mean stiffness than the TBW construct (16.4 N/mm vs 10.8 N/mm). The stiffness in all other planes of motion were similar between the two constructs. The mean ultimate load to failure in extension was 91.4 N for the HCS and 41.9 N for the TBW. The most common mode of failure was fracture of the dorsal lip of the proximal phalanx (13/16) for the HCS and bending of the K-wires (15/16) for TBW. CONCLUSIONS: Arthrodesis of the PIP joint using a HCS resulted in a construct that was significantly stiffer in extension with greater than double the load to failure compared to TBW. CLINICAL RELEVANCE: Although the stiffness required to achieve successful PIP joint arthrodesis has not been well quantified, the HCS proved to be the most favorable construct with respect to initial strength and stability.

Middle-phalanx-base radiographic morphology and its clinical implications.

The aim of this study was to establish normative values for the teardrop angle at the base of the middle phalanx. Our results showed a consistent mean teardrop angle in the range of 50°-51°, with no statistically significant difference observed between digits.Level of evidence: III.

Orthotic interventions for restoring proximal interphalangeal joint motion for patients with hand injuries or conditions: A systematic review and meta-analysis.

BACKGROUND: Limitations to proximal interphalangeal joint (PIPJ) motion can result in significant functional impairment for people with hand injuries and conditions. The role of orthotic intervention to improve PIPJ motion has been studied; however, high-quality systematic reviews and meta-analyses are lacking. PURPOSE: This study aimed to determine the effectiveness of orthotic intervention for restoring PIPJ extension/flexion following hand injuries or conditions. STUDY DESIGN: Systematic review. METHODS: A comprehensive literature search was completed in MEDLINE, CINAHL, Embase, Cochrane Central, and PEDro using terms related to orthoses, finger PIPJ range of motion, and randomized controlled trial design. Methodological quality was assessed using the PEDro score, study outcomes were pooled wherever possible using random effects meta-analysis, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation. RESULTS: Twelve trials were included (PEDro score: 4-7/10). The addition of orthotic intervention was not more effective than hand therapy alone following Dupuytren's release for improving total active extension (mean difference [MD] -2.8°, 95% confidence interval [CI]: -9.6° to 4.0°, p = 0.84), total active flexion (MD -5.8°, 95% CI: -12.7° to 1.2°, p = 0.70), Disability of the Arm, Shoulder and Hand scores (MD 0.4, 95% CI: -2.7 to 3.6, p = 0.79), or patient satisfaction (standardized MD 0.20, 95% CI: -0.49 to 0.09, p = 0.17). Orthotic intervention was more effective than hand therapy alone for improving PIPJ extension for fixed flexion deformities following traumatic finger injury or surgery (MD -16.7°, 95% CI: -20.1° to -13.3°, p < 0.001). No studies evaluated orthotic intervention to improve PIPJ flexion. CONCLUSION: The addition of an extension orthosis following procedures to manage Dupuytren's contracture is no better than hand therapy alone for improving PIPJ extension. In contrast, the addition of a PIPJ extension orthosis in the presence of traumatic PIPJ fixed flexion deformities is more effective for improving PIPJ extension than hand therapy alone. Future studies are needed to evaluate the role of orthotic intervention for improving PIPJ flexion.

Pyrolytic Carbon Hemiarthroplasty for Proximal Interphalangeal Joint Arthritis, Long-Term Follow-Up.

PURPOSE: The purpose of this study was to assess the long-term clinical, subjective, and radiographic results of pyrocarbon hemiarthroplasty for proximal interphalangeal joint (PIPJ) arthritis at a single institution. METHODS: Patients treated with a pyrolytic carbon hemiarthroplasty between 2005 and 2015 were contacted for a clinical follow-up visit. Patients were assessed before surgery, one year after surgery, and again after a mean of 11 years (range: 6-16 years). Objective outcomes were assessed with grip strength, pinch strength, and range of motion (ROM). Subjective outcomes were assessed by the Disabilities of the Arm, Shoulder, and Hand score, Canadian Occupational Performance Measure (performance and satisfaction), and Visual Analog Scale pain scores at rest and during activity. Radiographic assessments were completed according to Sweets and Stern as modified by Wagner et al. RESULTS: A total of 68 fingers in 52 patients underwent PIPJ hemiarthroplasty. Thirty-six arthroplasties in 29 patients were available for the long-term follow-up, five patients had died, and the remaining cases were contacted by phone. Three cases were lost to follow-up. Preoperative diagnoses included 41 fingers with osteoarthritis or posttraumatic arthritis, and 27 fingers with inflammatory arthritis. Eight cases had undergone revision at the time of follow-up, and the 10-year implant survival was 72%. The revisions were performed after a mean of two years after surgery. Three patients had undergone soft-tissue procedures. Visual Analog Scale pain scores, Disabilities of the Arm, Shoulder, and Hand scores, and Canadian Occupational Performance Measure scores improved significantly compared with that before surgery. Grip strength and pinch grip remained unchanged. However, PIPJ ROM deteriorated significantly one year after surgery, when compared with that before surgery. CONCLUSIONS: Pyrocarbon hemiarthroplasty of the PIPJ has an acceptable long-term implant survival, and the significant improvement in pain scores and patient-reported outcomes is maintained over time. Pyrocarbon hemiarthroplasty could be a viable option in the management of PIPJ arthritis. Patients should be advised that PIPJ ROM deteriorates over time. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.