| Low contact dynamic compression plate (LCD) with wrist arthrodesis |
Swanson silicone joint prostheses |
Second metacarpophalangeal joint silicone arthroplasty |
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There are radiocarpal and 2-5th metacarpophalangeal joint arthroplasties using silicone with titanium grommets. From Taljanovic, 2005 |
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| Silicone trapezium prosthesis |
Flexible wrist carpal bone fusion screw (SLIC {scapholunate intercarpal} screw repair system) |
Herbert screws used for proximal interphalangeal joint arthrodesis |
Left second metacarpophalangeal joint combined metal silicone arthroplasty |
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| From Taljanovic, 2005 |
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75 year-old man with severe osteoarthritis at the left index finger metacarpophalangeal joint. |
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| Silastic joint implants |
NeuFlex MCP Joint Implant System |
Antibiotic laden cement spacer |
Flexor digitorum Hunter rod tendon reconstruction |
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| 55 year-old woman with severe rheumatoid arthritis. Silastic implants replace the 2nd through 5th metacarpophalangeal joints. There is an arthrodesis at the thumb metacarpophalangeal joint with three K-wires, a tension band, and a splint. |
Middle-aged woman with rheumatoid arthritis. The implants contain a flexible, tear-resistant silicone rubber. |
36 year-old man with loss of index finger and a portion of the third metacarpal from a gunshot wound. The antibiotic laden cement block is stabilized by a small malleable plate and screws for treatment of third metacarpal bone infection. |
64 year-old man with planned staged flexor digitorum tendon reconstruction using a Hunter rod (arrow). |
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| Third generation "biaxial" total wrist prosthesis |
Multiple failed metacarpophalangeal (MCP) joint Swanson silicone arthroplasties |
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| 52 year-old woman with rheumatoid arthritis and left total wrist prosthesis which failed three years later and was replaced by a wrist arthrodesis. The distal stem of the prosthesis protruded out of the left 3rd metacarpal. The radiograph of the left wrist arthrodesis shows 2nd-5th MCP Swanson silicone arthroplasties, most of which are at least partially displaced. On the patient's right side there are also extensive changes of rheumatoid arthritis with multiple failed Swanson silicone MCP prostheses (see the two images to the right). |
52 year-old woman with severe rheumatoid arthritis in the right hand and wrist. There are multiple failed MCP Swanson silicone prostheses with partial displacement and bone fracturing. There is surgical arthrodesis at the right index finger MCP joint and bony fusion from long standing arthritis in the wrist and thumb MCP joint. In her left hand and wrist there was failure of a wrist prosthesis and failure of MCP joint arthroplasties (see the two images to the left). |
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| Fourth generation Total wrist arthroplasty (ReMotion Total wrist) |
Typical wrist arthroplasty components |
Spider plate |
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Image reproduced with permission from OrthoInfo. © American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
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The scaphoid has been removed. The spider plate transfixes the lunate, triquetrum, capitate, and hamate which are partially fused. |
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| Fourth generation total wrist arthroplasty (TWA) |
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| 69 year-old woman with rheumatoid arthritis. fourth generation wrist arthroplasty. There are also Silastic implants of the 2-5th proximal interphalangeal joints which are failing. |
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