PIPJ release little finger – Partial anterior teno-arthrolysis (PATA)
Subscribe to get full access to this operation and the extensive Upper Limb & Hand Surgery Atlas.
Learn the PIPJ release little finger – Partial anterior teno-arthrolysis (PATA) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the PIPJ release little finger – Partial anterior teno-arthrolysis (PATA) surgical procedure.
This is a step by step operative instruction for the volar release of the proximal inter-phalangeal joint (PIPJ) using the partial anterior teno-arthrolysis (PATA) method.
The total anterior teno-artholysis (TATA) for combined distal inter-phalangeal joint (DIPJ) and PIPJ contracture releases was first described by Mr P. Saffar, a French surgeon from the Institue de la main in Paris in 1978. The PATA is a similar procedure used for release of the PIPJ alone.
The procedure can be used in a number of pathologies including PIPJ trauma, volar plate injury, Dupuytren’s contracture, spasticity and post-operative contracture or post chronic regional pain syndrome contracture. As long as the articular surface of the joint is thought to be sound then this method may be applicable.
As with all surgeries of the PIPJ the release is likely to get the joint fully straight intra-operatively however, due to a combination of post-operative scarring and a poorly functioning extensor mechanism after prolonged stretching and dysfunction, the release often results in around a 50% improvement of deformity once the patient has fully recovered.
Following surgery the patient is placed in a volar plaster for a week and then a night extension splint and hand therapy following that. The splint maintains the extension while the finger is healing but also allows the extensor to tighten up to improve function. Final results are likely to present at 3-6months.
Compared to a joint arthrodesis, this technique and other joint release procedures, aims to maintain flexion at the PIPJ. A well positioned arthrodesis will allow the flexed finger out of the palm, which can itself be quite debilitating. The resulting lack of active flexion however, particularly in the case of the gripping fingers, little and ring, results in their main function of a tight grip being lost.
P Saffar, J P Rengeval. Total Anterior Tenoarthrolysis. Treatment of the Bent Fingers. Ann. Chir. Nov 1978;32(9):579-82.
Author:Mr Mark Brewster FRCS (Tr & Orth).
Institution: The Royal Orthopaedic Hospital, Birmingham, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.