Skip to content

Patients › Hand

Artritis ng DIPJ

PDF Evidence
Updated May 2026
Isang guhit-kamay na ilustrasyon ng isang walang mukhang matandang tao na nahihirapang isara ang maliit na pindutan ng damit gamit ang mapait at matigas na dulo ng mga daliri.
X-ray ng arthritis sa DIPJ: ang espasyo ng kasukasuan sa dulo ng daliri ay naglalapad at may maliit na bone spurs na bumubuo sa paligid ng nasira na cartilage — ang pattern na nagdudulot ng Heberden nodes. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring mararamdaman mo ang sakit at katigasan sa dulo ng iyong daliri, kung saan ang kasukasuan ay nagtatagpo sa kuko. Ito ang distal interphalangeal joint, o DIP joint. Karaniwang lumalala ang sakit pagkatapos gamitin ang iyong kamay para sa mga pang-araw-araw na gawain, tulad ng pag-abot sa likod para ikabit ang bra o pagtupi ng iyong kamiseta. Maaaring mapansin mo na mas malala ang sakit kapag gising ka pa lang sa umaga at bumababa ito habang gumagalaw ang iyong kamay.

Sa paglipas ng panahon, maaaring magbago ang hugis ng kasukasuan. Maaaring yumuko ang dulo ng iyong daliri papaloob, na lumilikha ng kurba na kilala bilang swan neck deformity. Nangyayari ito dahil nabuo ang flexion contracture sa kasukasuan, na nangangahulugan na nakakabit ito sa isang nakayuko na posisyon. Kung mayroon kang nakaraang sugat tulad ng mallet finger fracture, maaaring makita ang mga senyales ng wear-and-tear arthritis. Ang kondisyong ito ay sumusunod sa katulad na landas ng likas na pagtanda sa kasukasuan at nagdudulot ng pagbaba sa iyong saklaw ng galaw.

Maaaring maging mahirap ang pang-araw-araw na buhay kapag namamaga o nakakabit ang kasukasuan. Maaaring mahirapan kang hawakan ang mga bagay o gawin ang mga pinong galaw. Sa ilang kaso, tila hindi matatag o "naglalakbay" ang kasukasuan, na maaaring magdulot ng pagkalito kung maliit lamang ang nakikitang deformity. Bagama't maaaring mapaghirapan ang sakit, mahalagang malaman na ang mga nakikitang pagbabago sa X-ray ay hindi laging tumutugma sa dami ng sakit na nararamdaman mo. Titingnan ng iyong surgeon ang iyong partikular na mga sintomas upang gabayan ang iyong paggamot.

Ano ang nangyayari

Ang iyong distal interphalangeal joint (DIP joint) ay ang maliit na bisagra sa dulo ng iyong daliri. Sa loob nito, ang makinis na cartilage ay gumagana bilang shock absorber, na nagpapahintulot sa iyong mga buto na dumulas sa isa’t isa nang walang sakit. Kapag umusbong ang wear-and-tear arthritis, nababawasan ang patong na ito. Nagsisimulang magkuskusan ang mga buto nang direkta sa isa’t isa, na nagdudulot ng pakiramdam ng pagkikiskisan at katigasan na nararamdaman mo. Maaari ring hikayatin ng pinsalang ito ang joint na lumihis sa kanyang posisyon, kadalasang itulak ang dulo ng iyong daliri pabalik.

Ang tendon na yumuyuko sa dulo ng iyong daliri ay parang matibay na lubid na nakakabit sa buto. Kung mabali ang lubid na ito o kung maging unstable ang joint, hindi na maayos na mahihila ng tendon ang daliri. Minsan, nakakabit ang joint sa isang nakayuko na posisyon, na kilala bilang flexion contracture. Sa paglipas ng panahon, maaaring lumala ang deformity na ito, na nagiging sanhi ng hirap sa pagwasto ng iyong daliri o sa paggamit nito para sa mga pang-araw-araw na gawain.

Tinitingnan ng iyong surgeon kung gaano karami ang nasirang bahagi ng ibabaw ng joint upang matukoy ang pinakamainam na landas. Kung masyadong maliit ang buto para sa karaniwang mga turnilyo, o kung nakakabit ang joint sa isang masamang posisyon, kailangan ng espesyal na mga teknik. Ang layunin ay pigilan ang sakit at ibalik ang function, sa pamamagitan ng pagpapa-fuse ng mga buto o sa paggamit ng soft implant upang mapanatili ang ilang galaw. Layunin ng mga opsyong ito na bigyan ka ng ginhawa habang pinoprotektahan ang natitirang lakas ng iyong daliri.

Mga maaari naming gawin para dito

Maaari kang magsimula sa pamamagitan ng pag-aayos ng sakit sa sarili at pakikipagtulungan sa isang pisyikal na terapeuta. Ang pag-splint ng distal na interphalangeal na kasukasuan ay nagbabawas ng sakit at nagpapabuti ng extension nang hindi nagdudulot ng stiffness o paghihigpit sa iyong galaw. Gayunpaman, ang pagpapanatili ng tahimik na kasukasuan na ito ay magbabawas ng iyong kabuuang lakas ng hawak, na may epekto na lumalakas habang gumagalaw mula sa iyong hintuturo hanggang sa iyong maliit na daliri. Dapat mong bigyan ang mga non-surgical na paraang ito ng oras na gumana bago isaalang-alang ang mas invasive na hakbang.

Kung hindi sapat ang mga simpleng hakbang, maaaring pag-usapan ng iyong doktor ang mga medikal na opsyon upang pamahalaan ang iyong mga sintomas. Habang ang ebidensya ay nagbibigay-diin sa mga partikular na alternatibong operasyon, binabanggit nito na ang mga injeksyon tulad ng collagenase ay makakatulong sa mga joint contractures, bagama't kailangan mong bigyang-pansin ang panganib na bumalik ang problema. Para sa mga may malubhang sakit na apektado ang parehong gitna at dulo ng kasukasuan ng parehong daliri, madalas na inirerekomenda ang paggamot sa kanila nang sabay-sabay. Isaalang-alang din ng iyong doktor ang iyong personal na kalusugan, dahil ang mga salik tulad ng diabetes ay maaaring magdagdag ng panganib ng mga komplikasyon pagkatapos ng paggamot.

Kapag naabot na ng konservatibong alaga ang hangganan nito, maaaring isaalang-alang ang operasyon upang ihinto ang sakit o ibalik ang function. Maaaring pumili ang iyong doktor ng isang motion-preserving na prosedura upang panatilihin ang paggalaw ng iyong kasukasuan, o isang fusion upang i-lock ang kasukasuan sa lugar para sa katatagan. Sa ilang kaso, ginagamit ang silicone implant upang magbigay ng mahusay na pagpapagaan ng sakit at isang saklaw ng paggalaw na 30–40 degrees na may mababang kabuuang rate ng komplikasyon na 5%. Ang partikular na pamamaraan ay nakadepende sa kondisyon ng iyong kasukasuan at sa iyong mga layunin para sa pang-araw-araw na buhay.

Kailan kumonsulta sa doktor

Kumonsulta sa iyong doktor kung mayroon kang patuloy na sakit na hindi gumagaling kahit magpahinga, o kung nararamdaman mong mahina at hindi matatag ang iyong daliri. Humingi ng pagsusuri ng espesyalista kung ang iyong kasukasuan ay nakakabit, biglang sumusuko, o kung ang mga sintomas ay nakakaapekto sa iyong pagtulog o trabaho. Dapat ka ring humingi ng tulong kung napapansin mong biglang lumala ang mga sintomas. Magkaroon ng kaalaman na ang ilang kondisyon, tulad ng pinsala sa lumulutang distal interphalangeal na kasukasuan, ay maaaring magpakita ng minimal na deformity sa simula ngunit maaari pa ring magdulot ng arthritis sa hinaharap. Ang maagang diagnosis ay tumutulong na kilalanin ang mga isyung ito mula sa iba pang problema sa kasukasuan.

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Percutaneous DIP joint arthrodesis is advantageous compared with open fusion techniques in select patients [1].
  • Swan neck deformity progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Simultaneous surgical intervention is recommended for severe painful osteoarthritis of both the PIP and DIP joints of the same digit [3].
  • Denervation with cheilectomy presents a motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis [4].
  • Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods but with fewer major complications [5].
  • The combination of DIP arthrodesis and PIP Swanson arthroplasty results in favorable outcomes regarding simultaneous bony union and flexibility [7].
  • Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees [8].
  • Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [8].
  • The smile incision and reverse shotgun approach is a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary [9].
  • The nonaxial multiple small screws (NMSS) technique is a feasible option for DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required [11].
  • Customized structural bone grafting addresses bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction [13].
  • There is no difference in biomechanical performance between K-wires and compression screws for DIPJ arthrodesis [20].
  • Implant selection for DIPJ fusion should consider factors such as cost and complication profiles given the lack of difference in biomechanical performance between K-wires and compression screws [20].

Anatomy & Pathophysiology

  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].
  • Understanding of DIP joint morphology may lend insight into the biomechanics and disease progression within the DIP joints [10].
  • A substantial number of distal phalanges are too small to accommodate commonly available headless compression screws, particularly in females and the small finger [31].
  • Irreducibility was more commonly seen in dorsal than in volar dislocations of the DIP joint [33].
  • Volar dislocations of the DIP joint carried a higher risk of instability immediately after reduction compared to dorsal dislocations [33].
  • Biomechanically, dynamic tenodesis for the DIP joint using the remaining FDP tendon results in a flexion angle greater than 30 degrees [23].
  • In a cadaveric model, tenodesis successfully restored coordinated interphalangeal joint flexion after a simulated zone I FDP laceration with improvements in DIP joint flexion and composite finger flexion [35].
  • Lateral blocking with incremental joint angles allows a safer application of force for the healing tendon during palmar and lateral blocking exercises [26].

Classification

  • Swan neck deformity in the DIP joint progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Radiological osteoarthritis following a mallet finger fracture follows a similar course to the natural degenerative process in the DIP joint [12].
  • Post-traumatic osteoarthritis of the DIP joint after mallet finger fractures is accompanied by a decrease in range of motion, though this does not clinically affect patient-reported outcome measures (PROMs) [12].
  • The interrater reliability of the Kellgren & Lawrence classification system for post-traumatic osteoarthritis in the DIP joint after mallet finger fractures is considerably lower than initially assumed [34].
  • The interrater reliability of the OARSI classification system for post-traumatic osteoarthritis in the DIP joint after mallet finger fractures is considerably lower than initially assumed [34].
  • Current concepts regarding DIP joint osteoarthritis highlight the roles of cartilage, subchondral bone, and soft tissue structures in etiology, pathogenesis, and evaluation [19].
  • Morphological understanding of DIP joint curvatures may provide insight into the biomechanics and disease progression within the DIP joints [10].
  • Examination of type I and type II nerve endings provides new information on the sensory systems of the DIP joints and surrounding structures [32].
  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].

Clinical Presentation

  • Swan neck deformity in the DIPJ progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].
  • Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity [17].
  • Radiological osteoarthritis following a mallet finger fracture is similar to the natural degenerative process in the DIP joint [12].
  • Radiological osteoarthritis after a mallet finger fracture is accompanied by a decrease in range of motion of the DIP joint [12].
  • Radiological osteoarthritis after a mallet finger fracture does not clinically affect patient-reported outcome measures (PROMs) [12].
  • Primary synovial chondromatosis of the DIPJ is an extremely rare entity that requires accurate diagnosis to distinguish from other arthropathies [27].
  • Understanding the morphology of DIPJ curvatures may lend insight into the biomechanics and disease progression within the DIP joints [10].
  • Osteoarthritis of the DIPJ involves roles of cartilage, subchondral bone, and soft tissue structures in its etiology, pathogenesis, and evaluation [19].

Investigations

  • Percutaneous DIP joint arthrodesis is advantageous compared with open fusion techniques in select patients [1].
  • Swan neck deformity progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Simultaneous surgical intervention is recommended for severe painful osteoarthritis of both the PIP and DIP joints of the same digit [3].
  • Denervation with cheilectomy presents a motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis [4].
  • Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods with fewer major complications [5].
  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].
  • The combination of DIP arthrodesis and PIP Swanson arthroplasty results in favorable outcomes regarding simultaneous bony union and flexibility [7].
  • Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees with a low overall complication rate of 5% [8].
  • The smile incision and reverse shotgun approach is a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary [9].
  • Understanding the morphology of DIP joints may lend insight into the biomechanics and disease progression within the DIP joints [10].
  • The nonaxial multiple small screws (NMSS) technique is a feasible option for DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required [11].
  • Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint [12].
  • Radiological osteoarthritis after a mallet finger fracture does not clinically affect patient-reported outcome measures (PROMs) [12].
  • Customized structural bone grafting addresses bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction [13].
  • Immobilization of the distal interphalangeal joint of any finger reduces the overall grip strength of the hand [16].
  • The reduction in grip strength from DIP joint immobilization becomes progressively more pronounced from the index to the little fingers [16].
  • Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity [17].
  • Open reduction and internal fixation is a viable treatment option for chronic floating DIP joint injuries, though osteoarthritis may develop [17].
  • Arthrodesis of the distal interphalangeal joint often leads to complications [18].
  • Current concepts regarding DIP joint osteoarthritis examine the etiology, pathogenesis, and evaluation of the condition, highlighting the roles of cartilage, subchondral bone, and soft tissue structures [19].
  • A size mismatch existed between the anatomic dimensions of the DIP joint and commercially available headless compression screws [21].
  • A distinct collagen septum exists between the extensor tendon and skin at the DIP joint [38].

Treatment

  • Percutaneous DIP joint arthrodesis is advantageous compared with open fusion techniques in select patients [1].
  • Simultaneous surgical intervention is recommended for severe painful osteoarthritis of both the PIP and DIP joints of the same digit [3].
  • Denervation with cheilectomy presents a motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis [4].
  • Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods with fewer major complications [5].
  • Simultaneous anterograde screw arthrodesis of the DIP joint and silastic PIP joint replacement results in favorable outcomes regarding bony union and flexibility [7].
  • Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees [8].
  • Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [8].
  • The smile incision and reverse shotgun approach is a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary [9].
  • The nonaxial multiple small screws (NMSS) technique is a feasible option for DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required [11].
  • Customized structural bone grafting addresses bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction [13].
  • Diabetes and surgeon experience are factors increasing the risk of postoperative complications in DIP/thumb IP joint arthrodeses [14].
  • Splinting of the DIP joint reduces pain and improves extension at the joint without causing non-compliance, increased stiffness, or restriction of range of motion [15].
  • Open reduction and internal fixation is a viable treatment option for chronic floating DIP joint injuries, though osteoarthritis may develop [17].
  • Injection with collagenase Clostridium histolyticum is an option for the treatment of DIP joint contractures in Dupuytren disease, though the potential risk for recurrence should be carefully weighed [36].
  • Open DIP joint cheilectomy is a safe and effective alternative to DIP joint arthrodesis in patients with symptomatic osteoarthritis who wish to preserve joint motion [37].

Complications

  • Swan neck deformity in the DIPJ progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Palmar subluxation of a DIP joint is expected when more than one half of the dorsal articular surface is injured, even without preexisting arthritic deformity [6].
  • Radiological osteoarthritis following a mallet finger fracture follows a natural degenerative process and is accompanied by a decrease in DIPJ range of motion [12].
  • Diabetes is identified as a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
  • Surgeon experience is identified as a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
  • Arthrodesis of the distal interphalangeal joint often leads to complications [18].
  • Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [8].
  • Failed Swanson's arthroplasty of the DIPJ can result in bone stock loss and medullary absence [13].

Recovery

  • Percutaneous DIP joint arthrodesis is advantageous compared with open fusion techniques in select patients [1].
  • Swan neck deformity progresses significantly over time due to increasing DIPJ flexion contracture [2].
  • Simultaneous surgical intervention is recommended for severe painful osteoarthritis of both the PIP and DIP joints of the same digit [3].
  • Denervation with cheilectomy presents a motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis [4].
  • Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods but with fewer major complications [5].
  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].
  • The combination of DIP arthrodesis and PIP Swanson arthroplasty results in favorable outcomes regarding simultaneous bony union and flexibility [7].
  • Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees [8].
  • Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [8].
  • Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the DIP joint [12].
  • Radiological osteoarthritis after a mallet finger fracture is accompanied by a decrease in range of motion of the DIP joint [12].
  • The decrease in range of motion of the DIP joint following radiological osteoarthritis from a mallet finger fracture does not clinically affect PROMs [12].
  • Customized structural bone grafting addresses bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction [13].
  • Diabetes is a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
  • Surgeon experience is a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
  • Splinting of the DIP joint reduces pain and improves extension at the joint [15].
  • Splinting of the DIP joint does not give rise to non-compliance, increased stiffness, or restriction of range of motion [15].

Key Evidence

  • [L4] In select patients, this percutaneous DIP joint arthrodesis is advantageous in comparison with open fusion techniques. [1] (10.1007/s11552-010-9265-9)
  • [L5] The swan neck deformity in this individual progressed significantly with time because of increasing DIPJ flexion contracture. [2] (10.1016/j.jht.2009.11.005)
  • [L3] The authors recommend simultaneous surgical intervention in case of severe painful OA of the PIP and DIP joints of the same digit. [3] (10.1177/17531934231191255)
  • [L4] It presents a compelling motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis. [4] (10.1016/j.jhsa.2026.01.027)
  • [L4] The results obtained in this small series are equivalent to the traditional methods of DIP joint arthrodesis but with fewer major complications. [5] (10.1016/j.jhsa.2007.09.004)
  • [L5] Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured. [6] (10.1016/j.jhsa.2007.09.006)
  • [L4] The combination of DIP arthrodesis and PIP Swanson arthroplasty resulted in a favourable outcome in terms of simultaneous bony union and flexibility. [7] (10.1177/17531934231215790)
  • [L4] The study confirms that silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees with a low overall complication rate of 5%. [8] (10.1177/1753193411422679)
  • [L4] This technique may be a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary. [9] (10.1186/s12891-024-08016-6)
  • [L5] Our understanding of morphology may lend insight into the biomechanics and disease progression within the DIP joints. [10] (10.1007/s11552-014-9605-2)
  • [L4] Thus, the NMSS technique could be used as a feasible option in DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required. [11] (10.1186/s12891-022-05473-9)
  • [L4] Radiological OA after an MFF is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint, which does not clinically affect PROMs. [12] (10.1016/j.jhsa.2023.03.027)
  • [L4] A customized structural bone graft using the described technique addresses issues of bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction. [13] (10.1177/17531934231151217)
  • [L3] Diabetes and surgeon experience were identified as factors increasing the risk of postoperative complications in these DIP/thumb IP joint arthrodeses. [14] (10.1186/s12891-024-07361-w)
  • [L2] It does not give rise to non-compliance, increased stiffness or restriction of range of motion. [15] (10.1016/j.jht.2013.08.004)
  • [L4] Immobilization of the distal interphalangeal joint of any finger reduces the overall grip strength of the hand, with the effect becoming progressively more pronounced from the index to the little fingers. [16] (10.1177/1753193418765068)
  • [Case_report] Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity; open reduction and internal fixation is a viable treatment option for chronic cases, though osteoarthritis may develop. [17] (10.1016/j.jhsa.2010.05.025)
  • [L3] Arthrodesis of the distal interphalangeal joint often leads to complications. [18] (10.1177/17531934221111641)
  • [L5] This current concepts article examines the recent knowledge base regarding the etiology, pathogenesis, and evaluation of osteoarthritis of the distal interphalangeal joint, highlighting the roles of cartilage, subchondral bone, and soft tissue structures. [19] (10.1016/j.jhsa.2010.09.003)
  • [L5] Given the lack of difference in biomechanical performance between K-wires and compression screws, consideration should be given to other factors such as cost and complication profiles when choosing an implant for DIPJ fusion. [20] (10.1177/1558944715627211)
  • [L4] A size mismatch existed between the anatomic dimensions of the DIP joint and commercially available headless compression screws. [21] (10.1016/j.jhsa.2014.02.007)
  • [L5] Biomechanically, dynamic tenodesis for the DIP joint using the remaining FDP tendon is a valuable procedure because it results in a flexion angle greater than 30 degrees. [23] (10.1016/j.jhsg.2020.08.007)
  • [L5] This study supports the concept that lateral blocking with incremental joint angles allows a safer application of force for the healing tendon. [26] (10.1016/j.jht.2020.07.004)
  • [Case_report] Primary synovial chondromatosis of the distal interphalangeal joint is an extremely rare entity that requires accurate diagnosis to distinguish from other arthropathies. [27] (10.1177/15589447211049520)
  • [L4] A substantial number of distal phalanges are too small to accommodate commonly available headless compression screws, particularly in females and the small finger. [31] (10.1007/s11552-014-9679-x)
  • [L5] Our examination of the distribution of type I and type II nerve endings provides new information on the sensory systems of the DIP joints and surrounding structures. [32] (10.1016/j.jhsa.2010.11.050)
  • [L4] Irreducibility was more commonly seen in dorsal than in volar dislocations, while volar dislocations carried a higher risk of instability immediately after reduction. [33] (10.1177/1753193415616957)
  • [L4] The interrater reliability of the Kellgren & Lawrence and OARSI classification systems for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed. [34] (10.1016/j.jhsa.2024.03.012)
  • [L5] In this cadaveric model, this tenodesis successfully restored coordinated interphalangeal joint flexion after a simulated zone I FDP laceration with improvements in distal interphalangeal joint flexion and composite finger flexion. [35] (10.1016/j.jhsa.2013.10.009)
  • [L4] Injection with CCH is an option for the treatment of DIP joint contractures in Dupuytren disease, though the potential risk for recurrence should be carefully weighed prior to its use. [36] (10.1016/j.jhsa.2018.07.004)
  • [L4] Open DIP joint cheilectomy is a safe and effective alternative to DIP joint arthrodesis in patients with symptomatic osteoarthritis who wish to preserve joint motion. [37] (10.1016/j.jhsa.2017.07.006)
  • [L5] We confirmed the existence of a distinct collagen septum between the extensor tendon and skin at the DIP joint using MRI and histology. [38] (10.1016/j.jhsa.2008.11.030)

References

[1] Treatment of Symptomatic Distal Interphalangeal Joint Arthritis with Percutaneous Arthrodesis: A Novel Technique in Select Patients. HAND. 2010. DOI: 10.1007/s11552-010-9265-9 [2] Swan Neck Deformity after Distal Interphalangeal Joint Flexion Contractures: A Biomechanical Analysis. Journal of Hand Therapy. 2010. DOI: 10.1016/j.jht.2009.11.005 [3] Does distal interphalangeal joint arthrodesis affect proximal interphalangeal joint arthroplasty outcomes in the same finger?. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231191255 [4] Denervation with Cheilectomy of the Distal Interphalangeal Joint: Technique and Medium-Term Results. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.01.027 [5] Alternative to the Distal Interphalangeal Joint Arthrodesis: Lateral Approach and Plate Fixation. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.09.004 [6] A Biomechanical Study of Distal Interphalangeal Joint Subluxation After Mallet Fracture Injury. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.09.006 [7] Simultaneous anterograde screw arthrodesis of distal interphalangeal joint and silastic proximal interphalangeal joint replacement for osteoarthritis. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231215790 [8] Joint replacement in 131 painful osteoarthritic and post-traumatic distal interphalangeal joints. Journal of Hand Surgery (European Volume). 2011. DOI: 10.1177/1753193411422679 [9] Smile incision and reverse shotgun approach in distal interphalangeal joint arthrodesis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-08016-6 [10] Curvatures of the DIP Joints of the Hand. HAND. 2014. DOI: 10.1007/s11552-014-9605-2 [11] Distal interphalangeal joint arthrodesis with nonaxial multiple small screws: a biomechanical analysis with axial headless compression screw and clinical result of 15 consecutive cases. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-05473-9 [12] Posttraumatic Osteoarthritis of the Distal Interphalangeal Joint: A Follow-Up Study of 12 Years After Nonsurgical Treatment of Mallet Finger Fractures. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.03.027 [13] Salvage of failed Swanson’s arthroplasty of the distal interphalangeal joint. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231151217 [14] Arthrodesis of distal interphalangeal and thumb interphalangeal joint: a retrospective cohort study of 149 cases. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07361-w [15] Splinting of the Distal Interphalangeal Joint Reduces Pain and Improves Extension at the Joint; Results Front the Splint-OA Study. Journal of Hand Therapy. 2014. DOI: 10.1016/j.jht.2013.08.004 [16] Effect of immobilization of the distal interphalangeal joint of fingers on grip strength. Journal of Hand Surgery (European Volume). 2018. DOI: 10.1177/1753193418765068 [17] Floating Distal Interphalangeal Joint Injury: Case Report. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.05.025 [18] Risk factors in distal interphalangeal joint arthrodesis in the hand: a retrospective study of 173 cases. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221111641 [19] Osteoarthritis of the Distal Interphalangeal Joint. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.09.003 [20] Biomechanical Analysis of Internal Fixation Methods for Distal Interphalangeal Joint Arthrodesis. HAND. 2016. DOI: 10.1177/1558944715627211 [21] Distal Interphalangeal Joint Bony Dimensions Related to Headless Compression Screw Sizes. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.02.007 [23] The Effect of Flexor Digitorum Profundus Dynamic Tenodesis on the Distal Interphalangeal Joint: A Cadaver Study. Journal of Hand Surgery Global Online. 2020. DOI: 10.1016/j.jhsg.2020.08.007 [26] Tensile load on the flexor digitorum profundus tendon during palmar and lateral blocking exercises: Influence on blocking force and distal interphalangeal joint flexion angle. Journal of Hand Therapy. 2021. DOI: 10.1016/j.jht.2020.07.004 [27] Primary Distal Interphalangeal Joint Tenosynovial Chondromatosis of the Small Finger: A Case Report With Literature Review. HAND. 2022. DOI: 10.1177/15589447211049520 [31] Dimensional Analysis of the Distal Phalanx with Consideration of Distal Interphalangeal Joint Arthrodesis Using a Headless Compression Screw. HAND. 2014. DOI: 10.1007/s11552-014-9679-x [32] Distribution of Nerve Endings in Human Distal Interphalangeal Joint and Surrounding Structures. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.11.050 [33] Differences between dorsal and volar dislocations of the distal interphalangeal joint of fingers: a report of 30 cases. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193415616957 [34] Rater Agreement of Post-Traumatic Osteoarthritis of the Distal Interphalangeal Joint 12 Years After a Mallet Finger Fracture. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.012 [35] Tenodesis for Restoration of Distal Interphalangeal Joint Flexion in Unrepairable Flexor Digitorum Profundus Injuries. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.10.009 [36] Collagenase Clostridium histolyticum for the Treatment of Distal Interphalangeal Joint Contractures in Dupuytren Disease. The Journal of Hand Surgery. 2019. DOI: 10.1016/j.jhsa.2018.07.004 [37] Cheilectomy for Treatment of Symptomatic Distal Interphalangeal Joint Osteoarthritis: A Review of 78 Patients. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.07.006 [38] Dorsal Digital Septum of the Distal Interphalangeal Joint. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.11.030

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.