Metacarpophalangeal Joint Salvage Following Gunshot Wounds: A Case Series And Literature Review

Metacarpophalangeal (MCP) joint arthroplasty may be considered for patients with destructive gunshot wound (GSW) injuries. We present a review of two patients who sustained a low-velocity GSW of the hand with involvement of an MCP joint requiring MCP joint salvage using arthroplasty. Differing arthroplasty methods were used for each patient including pyrocarbon hemiarthroplasty and silicone arthroplasty. For pyrocarbon hemiarthroplasty, total arc of motion at 9 months after surgery for the MCP, proximal interphalangeal, and distal interphalangeal joints were 70º, 110º, and 80º, respectively. For silicone arthroplasty, total arc of motion at 9 months after surgery for the MCP, proximal interphalangeal, and distal interphalangeal joints were 85º, 120º, and 80º, respectively. Both patients returned to work without restrictions and were without chronic pain at the last follow-up 9 months from salvage surgery. The application of pyrocarbon or silicone arthroplasty for GSWs is a viable option for joint salvage in this population.