What is a PIPJ replacement?
You have undergone surgery to replace the middle joint in your finger (PIPJ) with a new PyroCarbon joint which is known as an arthroplasty. This may have been due to pain, limited movement or damage to your joint. You will need to undergo a strict hand therapy programme following this surgery to optimise your recovery.
What might I expect following surgery?
You will normally be seen by our hand therapy team within the first 1 to 2 weeks following your surgery. Following this you will then be seen on a regular basis to progress your hand therapy.
Following surgery it is important that you keep your dressing dry to avoid problems with your wound. Normally your stitches will be removed 10 to 14 days following your surgery. Once your wound is fully healed you will be shown how to use vasoline or an oil (such as sweet almond oil) to massage your scar to help prevent any excess scar tissue from causing problems and limiting the movement in your finger in the long term.
You will also be given advice regarding how to manage swelling in your finger. This may include elevating your hand above your heart level or through the use of compression (tape or sleeve).
Why is it important to protect my replaced joint?
You will be provided with a custom made thermoplastic splint which will be held in place with velcro straps on the back of your finger. This splint is designed to support the replaced joint and prevent you from over straightening your finger (hyperextension). From time to time your splint may need to be remoulded.
Why is it important to exercise my hand and replaced joint?
Exercises are important to help restore the movement and function of your hand. The exercises will help with preventing adhesions of scar tissue and reduce swelling.
You will be taught exercises which need to be performed on a regular basis throughout the day (normally five times daily). Exercises are completed with the splint in place on your operated finger unless advised by your hand therapist.
Weeks one to four
Gently bend the tip of your finger while supporting the middle joint of your finger in the splint.
Gently bend the middle joint of your finger towards the exercise board that you have been given, then straighten to the splint.
Each time you are seen by the hand therapist the angle on your board may be increased to allow more bend at your replaced joint, as it is able to tolerate it.
Use your other hand to gently stretch your finger to the splint, then hold it there on its own.
Week five onwards
Five to six weeks following your surgery you may commence unrestricted flexion of your hand with the following exercises, which will be taught to you by your hand therapist.
Week seven onwards
If you are struggling with bending your finger at seven to eight weeks after your surgery you may be taught to use your other hand to help stretch your operated finger into a bend. You will be advised by your therapist when to commence this exercise.
Use the other hand to stretch your finger into a bend.
You may be taught the following exercise if you are struggling to straighten your finger fully on its own. Use your other hand to stretch your finger straight. You will be advised by your therapist when to commence this exercise.
Use your other hand to stretch your finger straight by supporting the back of your hand with your index and middle fingers and use your thumb to push the finger straight.
What important advice should I follow?
- During the first four to five weeks you will only be able to complete light daily activities with your hand as you will risk damaging your finger and your replaced joint. You will be advised by your therapist when you can commence heavier activities and return to work.
- Driving is not advised for the first six weeks due to potential strain on the new joint.
- It is important that you keep your unaffected joints moving normally, including your shoulder, elbow, wrist and fingers.
- If you notice any sudden pain, swelling, redness or a change in your fingers ability to move or your splint becomes too loose or tight, please contact the hand therapy team.
Who should I contact if I have any problems?
If you have any problems or questions regarding your hand therapy please contact the hand therapy team on:
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
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