{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:26:59Z","timestamp":1787128019632,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Silicone arthroplasty of the proximal interphalangeal joint is traditionally performed through a dorsal approach, which requires violation of the extensor mechanism and may contribute to postoperative stiffness and extension lag. Volar approaches preserve the extensor apparatus and permit earlier active mobilization; however, previously described techniques differ in flexor sheath entry, volar plate management, and collateral ligament handling, limiting reproducibility. We describe a standardized volar technique that emphasizes controlled neurovascular mobilization; elevation of the A3 pulley as a laterally based flap (preserving A2 and A4); proximal disinsertion of the volar plate while maintaining its distal attachment; and bilateral complete proximal detachment of the proper collateral ligaments to achieve symmetric \u201cshotgun\u201d exposure. This collateral release corrects asymmetric ligament elongation or contracture in arthritic and post-traumatic deformities, restores coronal balance, and facilitates centered implant placement. Flexor tendons are retracted without division. After canal preparation and implant insertion, axial alignment and coronal and sagittal stability are assessed throughout the flexion-extension arc. The volar plate and collateral ligaments are not routinely repaired. Postoperative stability relies on implant-centered alignment and progressive peri-implant capsular fibrosis, with support from temporary buddy taping. This technique provides reproducible exposure while also serving as a structured soft-tissue rebalancing strategy. Clinical application should be limited to cases in which soft tissue balance can be restored and implant-centered stability achieved intraoperatively.<\/jats:p>","DOI":"10.1097\/bth.0000000000000563","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:00:09Z","timestamp":1784008809000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Standardized Volar Silicone PIP Arthroplasty: Bilateral Proximal Collateral Release and a Structured Non-Repair Strategy"],"prefix":"10.1097","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2511-023X","authenticated-orcid":false,"given":"Paula","family":"Anaya-Perez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3186-0014","authenticated-orcid":false,"given":"Pedro","family":"Bolado-Guti\u00e9rrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9]]},"reference":[{"key":"R1-20260819","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/S0030-5898(20)30835-X","article-title":"Implant resection arthroplasty of the proximal interphalangeal joint","volume":"4","author":"Swanson","year":"1973","journal-title":"Orthop Clin North Am"},{"key":"R2-20260819","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.jhsa.2004.03.008","article-title":"Long-term assessment of Swanson implant arthroplasty in the proximal interphalangeal joint of the hand","volume":"29","author":"Takigawa","year":"2004","journal-title":"J Hand Surg Am"},{"issue":"6 pt 1","key":"R3-20260819","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/S0363-5023(85)80154-4","article-title":"Flexible implant arthroplasty in the proximal interphalangeal joint of the hand","volume":"10","author":"Swanson","year":"1985","journal-title":"J Hand Surg Am"},{"key":"R4-20260819","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jhsa.2013.11.008","article-title":"Long-term results of Swanson silicone arthroplasty for proximal interphalangeal joint osteoarthritis","volume":"39","author":"Bales","year":"2014","journal-title":"J Hand Surg Am"},{"key":"R5-20260819","first-page":"139","article-title":"Proximal interphalangeal joint arthroplasty: the volar approach","volume":"2","author":"Schneider","year":"1991","journal-title":"Semin Arthroplasty"},{"key":"R6-20260819","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/BF02510430","article-title":"Der palmare Zugang zur Arthroplastik des proximalen Interphalangeal-Finger-Gelenks","volume":"5","author":"Simmen","year":"1993","journal-title":"Oper Orthop Traumatol"},{"key":"R7-20260819","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/BTH.0b013e31818c0f71","article-title":"The volar approach to proximal interphalangeal joint arthroplasty","volume":"13","author":"Duncan","year":"2009","journal-title":"Tech Hand Up Extrem Surg"},{"key":"R8-20260819","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.jhsa.2014.03.033","article-title":"Silicone proximal interphalangeal joint arthroplasty for primary osteoarthritis using a volar approach","volume":"39","author":"Proubasta","year":"2014","journal-title":"J Hand Surg Am"},{"key":"R9-20260819","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.jhsa.2015.11.013","article-title":"Surgical approaches to the proximal interphalangeal joint","volume":"41","author":"Cheah","year":"2016","journal-title":"J Hand Surg Am"},{"key":"R10-20260819","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1302\/2058-5241.4.180042","article-title":"The proximal interphalangeal joint: arthritis and deformity","volume":"4","author":"Herren","year":"2019","journal-title":"EFORT Open Rev"},{"key":"R11-20260819","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/PRS.0000000000009359","article-title":"An outcomes study of proximal interphalangeal joint silicone implant arthroplasty using the volar approach","volume":"150","author":"Riggs","year":"2022","journal-title":"Plast Reconstr Surg"},{"key":"R12-20260819","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0363-5023(05)80070-X","article-title":"Proximal interphalangeal joint silicone replacement arthroplasty: clinical results using an anterior approach","volume":"20","author":"Lin","year":"1995","journal-title":"J Hand Surg Am"},{"key":"R13-20260819","doi-asserted-by":"crossref","first-page":"1139e","DOI":"10.1097\/PRS.0000000000003260","article-title":"A systematic review of different implants and approaches for proximal interphalangeal joint arthroplasty","volume":"139","author":"Yamamoto","year":"2017","journal-title":"Plast Reconstr Surg"}],"container-title":["Techniques in Hand &amp; Upper Extremity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/BTH.0000000000000563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:00:11Z","timestamp":1787126411000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/BTH.0000000000000563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/bth.0000000000000563","relation":{},"ISSN":["1531-6572"],"issn-type":[{"value":"1531-6572","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"2026-02-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}