Proximal Interphalangeal Joint Dimensions for the Design of a Surface Replacement Prosthesis

Abstract

The bones from 83 proximal interphalangeal joints (PIPJs) were dissected in order to determine the shape and size of the articular surfaces. The bones were modelled in acrylic dental bone cement and the original bones and replicas were then sectioned and shadow-graphed. Dimensions were taken from these shadowgraphs to be used in the design of a surface replacement prosthesis for the PIPJ. It was found that the bi-condylar heads of the proximal and middle phalanges were circular in the sagittal plane as was the base of the middle phalanx. However, the radius of curvature of the middle phalangeal base was greater than that of the proximal phalangeal head indicating that the PIPJ is not a conforming joint. The alignment of the radial and ulnar condyles of the proximal phalangeal bones was investigated and it was found that the index and middle finger bones tended to have a more prominent ulnar condyle while the ring and little finger bones tended to have a more prominent radial condyle. This was due to a slight difference in diameters of the two condyles. The proximal phalangeal bone lengths L ranged from 29–52 mm, maximum head widths W from 8.5–15.5 mm and maximum diameters D of the best-fit circles to the sagittal profile of the bone head from 6–11 mm. The middle phalangeal bone lengths ranged from 16–35 mm, maximum head widths from 8.5–12 mm and maximum diameters from 5–7.5 mm. The relationships and ratios between these dimensions for the proximal and middle phalanges have been calculated.