Arthrodesis of the distal interphalangeal joint: description of a new technique and clinical follow-up at 2 years.
BACKGROUND
Arthrodesis of the distal interphalangeal joint (DIPJ) is an accepted operative procedure to treat osteoarthritis, instability and joint deformity. There is a wide spectrum of recommended operative techniques including cerclage wires, headless screws, bio-resorbable pins and lag screws. Lag screw fixation remains one of the most accepted methods of fixation; however, problems can occur in particular subsidence of the screw head leading to loss of compression and prominence of the screw head in the finger tip necessitating removal. We describe here a new technique of DIPJ arthrodesis that avoids these problems.


METHODS
The technique is described here in detail, and clinical results are given for 18 joints (17 patients) followed-up at a mean 24 months (range 6-44).


RESULTS
Mean post-operative DASH score was 15. There were no cases of non-union; only four complications were seen, one case of nail growth disturbance and one of early screw breakage necessitating revision. Two infections necessitated early hardware removal although both arthodesis were united.


CONCLUSIONS
The technique is simple and reliable giving consistent clinical results.
Olivier
L C
LC
Department of Traumatology, Hand and Reconstructive Surgery, St. Josefs-Hospital, Krankenhausstrasse 13, Cloppenburg, Germany. l.olivier@kh-clp.de
Gensigk
F
F
Board
T N
TN
Kendoff
D
D
Krehmeier
U
U
Wolfhard
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005384:Finger Joint / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011859:Radiography