Hand Joint Reconstruction with Rib Osteochondral Graft

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Journal of the Korean Society for Surgery of the Hand 1996;1(1):45-51.
Published online January 1, 1996.

Duke Whan Chung,Chung Soo Han,Young Suk Song

늑골의 골연골을 이용한 수부관절 재건술

정덕환,한정수,송영석

Abstract

Finger joints play a critical role in the function of the hand. Their function can be absent or disturbed by congenital malformation, trauma, or disease. The alternative for management of affected joints includes amputation, arthrodesis, fusion reconstruction with prosthesis or spacers, nonvascularized joint transfer, and vasoularized joint transfer. Arthrodesis or fusion can afford relief of pain, with stability, durability and good strength, but a cost of mobility. Despite constant improvement, prosthetic implants or spacers still present sign problems of stability, durability, and mobility. Surgeons have long sought to provide a biologic joint replacement using specialized tissues. There are methods using autograft, allograft, and osteochondral graft in nonvascularized joint transfer. In hand joint reconstruction use of the Swanson prosthesis have resulted in synovitis by silicone, component failure, and fatigue fracture. We performed hand joint reconstruction using rib osteochondral graft from 1993 to 1994. Etiologies of the joint defect were posttraumatic ankylosis 2 cases and one turnor resection case. Sites were proximal interphalageal joint in 1 case and metacarpophalangeal joint in 2 cases. Preoperative ranges of motion were fixed at posttraumatic ankylosis and destroyed joint surface by involvement of tumor tissue at bone tumor. Postoperative joint motion range averaged 45 at posttraumatic ankylosis and 80 finger flexion in tumor case. In conclusion, hand joint reconstruction using rib osteochondral graft can give good stability and create useful degrees of joint motion in ankylosing joints without using artificial material implant.

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