title: Arthrodesis of the thumb interphalangeal joint and finger distal interphalangeal joints with a headless compression screw.
abstract: OBJECTIVE
  To study the results of using a small, headless compression screw (AcuTwist) for thumb interphalangeal (IP) joint and finger distal interphalangeal (DIP) joint arthrodeses.
  
  
  METHODS
  Between November 2007 and January 2012, 48 primary arthrodeses of the thumb IP joint or DIP joint in the other digits were performed in 29 consecutive patients with AcuTwist devices. Indications for arthrodesis included 19 cases of osteoarthritis in 25 fingers, 3 cases of lupus in 9 fingers, 2 cases of post-traumatic osteoarthritis in 2 fingers, and 1 case and finger each of acute trauma, neuromuscular disorder, postinfectious osteoarthritis, boutonniere deformity, and Dupuytren contracture. Charts were reviewed for clinical data, and radiographs were assessed for alignment and healing.
  
  
  RESULTS
  Age averaged 59 years and follow-up averaged 12 months (range, 2-50 mo). Union occurred in 43 out of 46 fingers (94%). There were no cases of nail deformity, wound complications, tip hypersensitivity, or clinically notable malalignment. Three arthrodeses failed to fuse, including 2 asymptomatic nonunions and 1 fixation loss requiring revision with autograft. The complication rate was 9%.
  
  
  CONCLUSIONS
  Distal digital joint arthrodesis with the AcuTwist resulted in a fusion rate of 94% with a complication rate of 9%. Our rate of fusion compares favorably with prior series using other methods of fixation.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Permanente Medical Group, Walnut Creek, California. Electronic address: chriscoxmd@gmail.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.affiliation: Department of Orthopaedic Surgery, Permanente Medical Group, Walnut Creek, California.
authors.forename: Brandon E
authors.initials: BE
authors.lastname: Earp
authors.affiliation: Department of Orthopaedic Surgery, Permanente Medical Group, Walnut Creek, California.
authors.forename: W Emerson
authors.initials: WE
authors.lastname: Floyd
authors.affiliation: Department of Orthopaedic Surgery, Permanente Medical Group, Walnut Creek, California.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Blazar
mesh_terms: D001174:Arthrodesis / Q000295:instrumentation*; D001863:Bone Screws; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005385:Fingers / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D013933:Thumb / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Arthritis; DIP; arthrodesis; distal interphalangeal; variable pitch