Developing a methodology for analysis and manufacturing of proximal interphalangeal (PIP) joint using rapid prototyping technique

2015 ◽  
Vol 21 (4) ◽  
pp. 449-460 ◽  
Author(s):  
Emad Abouel Nasr ◽  
Abdurahman Mushabab Al-Ahmari ◽  
Hazem Alkhawashki ◽  
Abdulsalam Altamimi ◽  
Mohammed Alkhuraisi
Keyword(s):  
Rapid Prototyping ◽  
Range Of Motion ◽  
Relative Motion ◽  
Equivalent Stress ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Implant Design ◽  
Content Type ◽  
Stress And Deformation ◽  
The Stability

Purpose – The purpose of this paper is to design and analyze four proximal interphalangeal joint (PIP) prosthesis thorough finite element analysis (FEA) and fabricate them using rapid prototyping (RP) technique. Arthritis of the finger joints is an important pathology of the hand. Major complaints in arthritis are stiffness, deformity and severe pain. The pain is due to the inflammatory process that occurs due to pathology, which involves joint degeneration, synovial swelling and ligament and muscle stiffness. Among the surgical treatment of arthritis is Arthroplasty which involves replacing the diseased joint with an artificial joint. Design/methodology/approach – In this paper, four proximal interphalangeal joint (PIP) prostheses are designed, analyzed using FEA and fabricated using rapid prototyping technique. Four different prostheses “BM”, “IMP”, “IMP2” and “FINS” are designed using CATIA software and tested by normal daily functions such as grasp, key pinch and tip pinch tests using FEA to analyze the results based on their stress and deformation. Finally, the prostheses are fabricated using electron beam melting technology. Findings – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant. The ANSYS summary results were analyzed depending on the minimal results of equivalent stress and deformation from the taken tests that have happened on the designed prosthesis. The results conclude that, in the grasp test, the minimal equivalent stress and deformation have happened on the “BM” and “IMP2” implants. Furthermore, in the key pinch test, minimal equivalent stress and deformation occurred on the “FINS” implant, and finally, in the tip pinch, minimal equivalent stress occurred on the “FINS” and minimal deformation has happened on the “IMP2” implant. Research limitations/implications – These results conclude that both “IMP2” and “FINS” share the minimum results in the taken tests, and this shows that these implants may be further studied brainstormed upon to aid innovation of a better implant design that shares both of these implants’ features and shape. Nevertheless, testing in an in vivo or in vitro model to prove more of the effectiveness of these implants should be taken into consideration, and to test how the prostheses will function in an actual environment, a simulated hand can be designed and made to discover the true forces and mechanics of the fingers and the hands with the prosthesis that is implanted, as well as to know if the hand works properly. Originality/value – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant.

scholarly journals Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 669-674
Author(s):  
Pieter W. Jordaan ◽  
Duncan McGuire ◽  
Michael W. Solomons
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Retrospective Review ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surface Replacement ◽  
Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

Novel antimicrobial materials designed for the 3D printing of medical devices used during the COVID-19 crisis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Samuel Furka ◽  
Daniel Furka ◽  
Nitin Chandra Teja Chandra Teja Dadi ◽  
Patrik Palacka ◽  
Dominika Hromníková ◽  
...  
Keyword(s):  
3D Printing ◽  
Rapid Prototyping ◽  
Medical Devices ◽  
Hybrid Material ◽  
Weight Ratio ◽  
Layered Silicate ◽  
Content Type ◽  
Antimicrobial Materials ◽  
The Stability ◽  
Designed Materials

Purpose This study aims to describe the preparation of antimicrobial material usable in 3D printing of medical devices. Despite the wealth of technological progress at the time of the crisis caused by SARS-CoV-2 virus: Virus that causes current Pandemic situation (COVID-19), the global population had long been exposed beforehand to an acute absence of essential medical devices. As a response, a new type of composite materials intended for rapid prototyping, based on layered silicate saponite (Sap), antimicrobial dye phloxine B (PhB) and thermoplastics, has been recently developed. Design/methodology/approach Sap was modified with a cationic surfactant and subsequently functionalized with PhB. The hybrid material in powder form was then grounded with polyethylene terephthalate-glycol (PETG) or polylactic acid (PLA) in a precisely defined weight ratio and extruded into printing filaments. The stability and level of cytotoxicity of these materials in various physiological environments simulating the human body have been studied. The applicability of these materials in bacteria and a yeast-infected environment was evaluated. Findings Ideal content of the hybrid material, with respect to thermoplastic, was 15 weight %. Optimal printing temperature and speed, with respect to maintaining antimicrobial activity of the prepared materials, were T = 215°C at 50 mm/s for PETG/SapPhB and T = 230°C at 40 mm/s for PLA/SapPhB. 3 D-printed air filters made of these materials could keep inner air flow at 63.5% and 76.8% of the original value for the PLA/SapPhB and PETG/SapPhB, respectively, whereas the same components made without PhB had a 100% reduction of airflow. Practical implications The designed materials can be used for rapid prototyping of medical devices. Originality/value The new materials have been immediately used in the construction of an emergency lung ventilator, Q-vent, which has been used in different countries during the COVID-19 crisis.

A novel technique for proximal interphalangeal joint fracture-dislocations: the second toe middle phalanx osteochondral graft

2021 ◽  
pp. 175319342110292
Author(s):  
Danielle Nizzero ◽  
Nicholas Tang ◽  
James Leong
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Joint Fracture ◽  
Acute Injuries ◽  
Fracture Dislocations ◽  
Chronic Injuries ◽  
Second Toe

Many different surgical techniques have been used to treat unstable dorsal proximal interphalangeal joint fracture-dislocations. The authors have used the base of the middle phalanx of the second toe base as an alternative autograft to treat this type of injury. This retrospective study assessed the clinical outcomes of this procedure in 11 patients. Range of motion, grip strength, Disability of the Arm, Shoulder and Hand score and donor site morbidity were assessed at regular intervals postoperatively. Nine patients had acute injuries and two had chronic injuries. The mean range of motion in the proximal interphalangeal joint at final review was 65° for patients with acute injuries and 41° for patients with chronic injuries. Other outcomes were satisfactory and there were no complications. Level of evidence: IV

A NOVEL ARTIFICIAL PROSTHETIC REPLACEMENT FOR THE PROXIMAL INTERPHALANGEAL JOINT OF THE HAND — FROM CONCEPT TO PROTOTYPE

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 159-168 ◽  
Author(s):  
S. P. Chow ◽  
K. W. Lam ◽  
I. Gibson ◽  
A. H. W. Ngan ◽  
W. Lu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Prosthesis ◽  
Prosthetic Replacement ◽  
Optimal Range ◽  
Alloy Material ◽  
Pip Joint ◽  
Cobalt Chrome Alloy ◽  
Cobalt Chrome

This article describes the development of a proximal interphalangeal (PIP) joint prosthesis based on the principles of replicating anatomical surface components, the use of macrolocking intramedullary stem and the use of a cobalt-chrome alloy material. The design features are intended to obtain an optimal range of motion while retaining stability and longevity. The final prototype, for which a patent has been filed, is described.

Internal Fixation of Unstable Fracture Dislocations of the Proximal Interphalangeal Joint

2005 ◽  
Vol 30 (5) ◽  
pp. 492-498 ◽  
Author(s):  
I. GRANT ◽  
A. C. BERGER ◽  
S. K. Y. THAM
Keyword(s):  
Range Of Motion ◽  
Early Mobilization ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Unstable Fracture ◽  
Group Operation ◽  
Chronic Group ◽  
Acute Group ◽  
Palmar Plate ◽  
Fracture Dislocations

We report a group of 14 patients with fracture dislocations of the proximal interphalangeal joint with fracture fragments of adequate size to allow reduction of the proximal interphalangeal joint and internal mini screw fixation of the bone fragment attached to the palmar plate to the base of the middle phalanx. Three years after surgery, (range 25–52 months) the average total active range of motion of the proximal interphalangeal joint was 100° (range 65–115°) for the acute group (operation within 14 days of injury, n = 7) and 86° (range 60–110°) for the chronic group (operation on average 46 days after injury, range 21–120 days, n = 7). Longer delay from injury was associated with a decreased total range of motion ( P = 0.028). Further subluxation occurred in three chronic group patients, one required further surgery. The key to successful treatment of this injury is the re-establishment of joint congruity and early mobilization. With appropriate patient selection, pain free, satisfactory range of motion can be achieved. There is a risk of persistent subluxation or dislocation, particularly if treatment is delayed.

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

MatOrtho proximal interphalangeal joint arthroplasty: minimum 2-year follow-up

2016 ◽  
Vol 41 (9) ◽  
pp. 910-916 ◽  
Author(s):  
O. Flannery ◽  
O. Harley ◽  
R. Badge ◽  
A. Birch ◽  
D. Nuttall ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Cobalt Chromium ◽  
Retrospective Case ◽  
Replacement Arthroplasty ◽  
Functional Scores ◽  
The Mean

The MatOrtho proximal interphalangeal replacement is a cementless cobalt–chromium metal-on-polyethylene mobile-bearing surface replacement arthroplasty. The aim of this study is to report the outcome and complications of this implant at a minimum of 2 years follow-up from a single institution. A retrospective case review was performed on all MatOrtho proximal interphalangeal joint replacements performed with a minimum of 2 years follow-up. Patient demographics, diagnosis, implant revision and other surgical interventions were recorded. Subjective and objective outcomes were evaluated at latest follow-up, including pain scores, range of motion, function and radiographic assessment. A total of 109 implants were inserted in 56 patients. Nine implants (six patients) were lost to follow-up. Of the remaining 100 implants, 75 had been undertaken in females. The mean age at time of surgery was 64 years and the principal diagnosis was osteoarthritis in 74%. The mean follow-up was 47 months (range 24–77). Within the group there was a statistically significant diminution in pain. There was also an improvement in functional scores post-operatively. Improvement in range of motion was seen in those joints with a pre-operative range of motion greater than 20°. Radiologically there was no evidence of loosening or of implant subsidence at final follow-up. The revision rate was 13%. Nine joints were revised to the NeuFlex (silicone rubber) prosthesis, three were converted to an arthrodesis and one had exchange of the MatOrtho prosthesis. The survival of the MatOrtho proximal interphalangeal joint arthroplasty was 85% at a minimum of 2-years follow-up. Patients can be advised that the procedure achieves good pain relief, improvement in functional scores and may improve range of motion. We would, however, caution against this implant’s use in joints that are either stiff or have significant deformity and/or instability pre-operatively.

scholarly journals Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited

2018 ◽  
Vol 6 ◽  
Author(s):  
Cheng Hean Lo ◽  
Simone H. Nothdurft ◽  
Hye-Sung Park ◽  
Eldho Paul ◽  
James Leong
Keyword(s):  
Range Of Motion ◽  
Rating Scale ◽  
Rubber Band ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dash Score ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pin Site ◽  
Traction System

Abstract Background The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes. Methods Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study. Patients underwent dynamic skeletal distraction using the modified (Deshmukh) pins rubber band traction system. Outcomes were measured using the Nominal Rating Scale for pain; Disabilities of the Arm, Shoulder, and Hand (DASH) score; active and passive range of motion; patient rating scale; and complications. Results Twenty patients underwent the procedure, and 19 were included in analyses. At the final follow-up assessment, an average of 62° and 77° was achieved for proximal interphalangeal joint active and passive range of motion, respectively. Pain levels were low (median score of 0 at rest and 1 ranging, out of 10). Four patients suffered minor pin site infections. Conclusion Distraction ligamentotaxis is a useful part of the armamentarium, especially in the absence of more suitable procedures. It is important to select appropriate patients, educate, and ensure adherence to postoperative therapy. Employing the Deshmukh frame modification streamlines the theatre processes, and removal of wires at approximately 4 weeks minimizes risk of pin site infection.

Dynamic External Fixator for Pilon Fractures of the Proximal Interphalangeal Joints: A Simple Fixator for A Complex Fracture

2003 ◽  
Vol 28 (2) ◽  
pp. 137-141 ◽  
Author(s):  
A. A. SYED ◽  
M. AGARWAL ◽  
R. BOOME
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
External Fixator ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
High Patient Satisfaction ◽  
Complex Fracture ◽  
Effective Dynamic ◽  
Pilon Fractures

We describe a very cheap, simple and effective dynamic external fixator for treatment of pilon fractures of the proximal interphalangeal joint. At final follow-up, nine such fractures had regained an average range of motion of 79° (range, 65–90°). There was high patient satisfaction and there were no serious complications.

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