We evaluated Silastic implant arthroplasty in the metacarpophalangeal
joints of rheumatoid patients by a prospective analysis of the cases of
twenty-eight patients. One hundred and fifteen such implants were followed
for an average of fifty-four months (range, twenty-four to 125 months). The
postoperative active motion of the metacarpophalangeal joint averaged 43
degrees, from 13 degrees of extension to 56 degrees of flexion. The average
range of active motion of the metacarpophalangeal joint increased 17
degrees over preoperative values. Ulnar drift recurred in forty-nine
fingers (43 per cent), and fracture of the spacer occurred in twenty-four
joints (21 per cent). The sites of three spacers became infected, and
treatment required the amputation of one finger. Preoperative and
postoperative key pinch and grip strengths were unchanged. Patient
satisfaction was high; twenty patients (71 per cent) experienced
significant pain relief, nineteen patients (68 per cent) felt that they had
much better hand function, and twenty-three patients (82 per cent) thought
that the cosmetic appearance of the hand was improved.