Proximal Interphalangeal Joint Synovectomy

Proximal interphalangeal synovectomy for surgical treatment of rheumatoid arthritis of the hand joint. Treating diseases: synovitis Indication Proximal interphalangeal synovectomy applies to: 1, simple synovitis, without finger deformity. 2, with mild finger deformity of synovitis, the deformity can be treated by non-surgical methods. Surgical procedure 1. Incision With the joint as the center, a longitudinal arc-shaped incision is made on the back of the finger to the temporal side, and the incision is 3 to 4 cm long. When cutting the skin, take care to avoid damage to the dorsal vein of the finger so as not to affect the venous return of the affected limb. 2, revealing the synovium It enters between the central iliac crest and the lateral bundle, and can also enter from the temporal side of the dorsum of the finger. After separating the finger dorsal aponeurosis and the dorsal joint capsule with a small stripper, the central tendon bundle is pulled toward the ulnar side, the iliac crest is pulled toward the iliac crest, or the entire phalanx is pulled toward the ulnar side to reveal A thin, dorsal joint capsule. The dorsal joint capsule is cut transversely, and the synovial membrane bulges. 3, remove the synovium The dorsal synovial membrane was removed, the granulation tissue at the edge of the articular cartilage surface was scraped, the proximal interphalangeal joint was flexed and pulled distally, and the joint space was enlarged to scrape off the synovial tissue on both sides of the joint and the volar side. 4, suture incision Relax the tourniquet, completely stop bleeding, flush with isotonic saline and inject 0.2 ml of acetic acid peptone, suture the incision of the aponeurosis with a 4-0 non-absorption line, and suture the incision layer by layer.