The impact of various simulated arthrodesis angles of the proximal interphalangeal joint of the ring and middle finger on grip strength. 2022

Jieying Xu, and Fok Chuan Yong, and Celestine Wenxian Lim, and Kevin Jian Hao Wong, and Lam Chuan Teoh
Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore. Jieying.xu@mohh.com.sg.

BACKGROUND Arthrodesis of the proximal interphalangeal (PIP) joint at 40° angle has been proposed by many authors. A smaller angle of arthrodesis results in weaker grip strength of the hand from the quadriga effect. However, arthrodesis at 40° compromises other aspects of hand function including poor aesthetic appearance. This paper aims to quantify the decrease in grip strength at 40°, 20°, and 0° of arthrodesis. METHODS Grip strengths of the hand were measured using a BASELINE dynamometer at settings II, III, and IV. Baseline grip strength of the subjects were first measured without wearing a splint. Thereafter, subjects wore thermoplastic splints to simulate arthrodesis of the middle and ring finger PIP joint at 40°, 20°, and 0°, and grip strengths were measured again. The grip strength of the hand with simulated arthrodesis was then calculated as a ratio of the baseline. RESULTS There were 50 subjects yielding 100 sets of results. The results show that average grip strength ratio of the hand decreases progressively from 40° and 20° and to 0° of arthrodesis for both the middle and ring finger. However, the difference in grip strength ratio between 40° and 20° of arthrodesis was minimal. Simulated arthrodesis of the middle finger affected the grip strength ratio more than arthrodesis of the ring finger, and compromised gripping of a smaller handle more than a wider one. CONCLUSIONS The decrease in grip strength from 40° to 20° simulated fusion of PIP joint was minimal. Therefore, in so far as grip strength loss is concerned, arthrodesis of the PIP joint at an angle less than 40° can be considered for patients with individual functional and aesthetic concerns.

UI MeSH Term Description Entries
D005384 Finger Joint The articulation between the head of one phalanx and the base of the one distal to it, in each finger. Interphalangeal Joint of Hand,Interphalangeal Joint of Finger,Finger Interphalangeal Joint,Finger Interphalangeal Joints,Finger Joints,Hand Interphalangeal Joint,Hand Interphalangeal Joints,Joint, Finger,Joints, Finger
D005385 Fingers Four or five slender jointed digits in humans and primates, attached to each HAND. Finger
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001174 Arthrodesis The surgical fixation of a joint by a procedure designed to accomplish fusion of the joint surfaces by promoting the proliferation of bone cells. (Dorland, 28th ed) Arthrodeses
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint
D018737 Hand Strength Force exerted when gripping or grasping. Grasp,Grip,Grip Strength,Hand Grip Strength,Grasps,Grip Strength, Hand,Grips,Strength, Grip,Strength, Hand,Strength, Hand Grip

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