Small Joint Reconstruction of the Hand

Pain, loss of motion, and instability in the small joints of the hand can result in debilitating loss of function and deformity. Salvage procedures are considered in the setting of complex nonreconstructable fractures, after failure of initial fracture treatment, and for the treatment of severe joint arthritides. This article reviews the merits of various reconstructive options in these settings and examines the pertinent anatomy, clinical challenges, and risk-benefit profiles of each option. The review is limited to salvage reconstructive procedures of the small joints of the hand.