A Literature Review of "Failures" of the Swanson Finger Prosthesis in the Metacarpophalangeal Joint

This paper reviews the use of the Swanson finger prosthesis, concentrating on clinical results from the metacarpophalangeal (MCP) joint and modes of prosthetic "failure". While "failure" is generally associated with fracture, it is recognised that fracture does not always necessitate replacement of the Swanson prosthesis. Fracture tends to occur at the junction of the distal stem and hinge of the prosthesis. Initial improvements in ulnar deviation and range of motion (ROM) tend to be gradually reduced over the duration of implantation, and there is little evidence to suggest any long-term improvement in hand strength. Bone erosion and silicone synovitis have been seen but at a much lesser incidence than in other joints implanted with silicone spacers. An evaluation of retrieved Swanson prostheses, tied in with patient history and hand measurements might provide additional information to improve the design of the Swanson prosthesis itself and of other finger prostheses.