Pearls

• Grommets are not indicated for use with Silastic implants in the PIPjoints.

• Using the volar approach to the PIP (when indicated) minimizes the risk of damage to the central slip insertion and can be performed simultaneously with a tenolysis to break up adhesions between the FDP and FDS as is commonly seen in long-standing arthritic fingers.

• The implant stems should slide freely in the medullary canal without buckling. If the appropriate size necessary has a stem length that prevents this, the stem should be shortened up to 5 mm to prevent such buckling.

• The largest size implant that fits the space is generally preferred. Implants smaller than size 1 may allow bony overgrowth to bridge and ankylose the joint.

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

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