PIPJ Arthroplasty Without Fixation

Abstract

The PIPJ arthroplasty is one of the most common surgical foot procedures performed today. The evolution and refinement of surgical PIPJ procedures have made the “non-fixated” arthroplasty much less common. It however still has its place and will be discussed with a recent case involving an elderly diabetic patient. Multiple factors played into the decision-making, which include the patient age (77), activity level (moderate/low), and mild cellulitis within the digit, and the most significant was an open pressure lesion on the distal third toe. A PIPJ arthroplasty with transverse elliptical incision was used. Additionally after appropriate bone resection off the head of the proximal phalanx, an extensor tendon shortening was used to assist a skin wedge removal to obtain the needed correction to remove the pressure on the distal toe.