Prosthesis
Custom-Made Cement Spacer to Replace a PIP-Infected Prosthesis: A Case Report and Review of Therapeutic Options
By Camillo Fulchignoni, Silvia Pietramala, Giulia Frittella and 5 others.
Abstract
Background
Use of a prosthesis to replace small hand joints, mainly in patients with degenerative osteoarthritis or with sequelae of fractures, is more and more common. As for other joints, use of a prosthesis usually leads to good functional results but is not free of complications such as implant infection. We discuss a possible solution by presenting a single case treated by means of a custom-made spacer in our hospital and comparing it to the very few options available in the literature.
Methods
A 30-year-old active male, treated in another hospital two years before for an articular fracture of the middle phalanx of the ring finger of his left hand, came to our center with a rigid digit. He was therefore treated with a Swanson proximal interphalangeal (PIP) joint prosthesis. At one-month follow-up, the patient presented clear signs of infection of his implant. The authors removed the infected implant and replaced it with a small custom-made antibiotic-impregnated cement spacer. The patient underwent a long-lasting postoperative oral antibiotic therapy. Four months later, a new Swanson prosthesis was successfully implanted. A literature review was performed.