Anatomie des Fingergrund- und -mittelgelenks unter Berücksichtigung der Endoprothetik

BACKGROUND: Precise knowledge of the anatomy and biomechanics of the metacarpophalangeal and proximal interphalangeal joint is the basis for both indication and implantation of a finger joint prosthesis. Currently available finger joint prostheses inadequately take into account individual, ethnological, gender, age, and side differences. They can remain compromised despite the possible combination of their components.

OBJECTIVES: To elucidate which problems of finger joint arthroplasty exist due to the anatomy and biomechanics of the metacarpophalangeal and proximal interphalangeal joints.

METHODS: The anatomy and biomechanics of the metacarpophalangeal and proximal interphalangeal joint are described, and the problems and solutions of finger joint arthroplasty are presented.

RESULTS: Despite precise knowledge of the anatomy and biomechanics of the metacarpophalangeal and proximal interphalangeal joint, not all problems of finger joint arthroplasty have been solved. However, a modular surface replacement appears promising for the proximal interphalangeal joint.

CONCLUSIONS: Artificial joint replacement of the metacarpophalangeal and proximal interphalangeal joint is difficult with regard to morphology, small bone dimensions, complex biomechanics, and the strain of the hand. Further improvements, especially in design, should be achieved by exact anatomical imitation.