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DIP Joint Fusion

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DIP joint fusion stabilizes and reduces pain in the fingertip joint, often for arthritis or mallet finger.

Updated May 2026

A hand-drawn illustration of a faceless person trying to pick up a small coin with stiff fingertips. — X-ray after a DIP joint fusion: the small joint nearest the nail has been locked into one solid unit. The bones grow together over a few weeks, removing the joint pain at the cost of bending. Kieran Hirpara 4.0

Why this operation has been suggested¶

This page reflects how Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic. We reach patients through GP or physiotherapist referral. A clinic assessment establishes your diagnosis. For long-standing wear-and-tear arthritis, we usually try non-operative care first. This includes activity changes, hand therapy, splinting, and injections. We consider surgery when these steps have not given enough improvement.

DIP joint fusion joins the last finger bone to the middle one. This creates a stable, pain-free end to your digit. Your surgeon may recommend this if you have severe pain or instability that limits daily tasks. The goal is to stop the joint from moving so it no longer hurts. This allows you to grip and hold objects without discomfort. While fusion stops motion, it provides the stability needed for reliable hand function. We discuss this as a shared decision to help you return to your routine with less pain.

Before the operation¶

Please arrange for someone to drive you home after your procedure. You must fast from food and drink for six hours before your anaesthetic. Your surgeon will provide specific instructions on which medications to pause. Bring a complete list of your current medicines to the hospital. You may need blood tests or an anaesthetic review to ensure you are safe for surgery. We will also take X-rays to confirm the joint details. Wear loose, comfortable clothing to make getting ready easier. Please arrive on time so we can prepare you for your open operation with a single incision.

On the day¶

You will arrive at the hospital or surgical centre a short time before your procedure. Your surgeon will meet you to confirm the details and answer any final questions. You will then meet the anaesthetist, who will discuss pain control and safety measures tailored to your needs. This operation can be done under local anaesthetic (an injection that numbs just the area of surgery, with you awake) or under general anaesthetic (fully asleep). Most people choose local — recovery is quicker and you can go home soon after. If you'd prefer to be asleep, that's also a reasonable choice — discuss it with your surgeon and anaesthetist.

Once you are ready, you will be taken into the operating theatre. Your surgeon performs this as an open approach using a single conventional incision over the operative site. This allows clear access to the joint for fusion. The surgery itself is straightforward, though we will not detail the steps here as that is covered in the next section. After the procedure, you will wake up in the recovery area where nurses will monitor your comfort and circulation. You can expect to go home the same day once you are stable and pain is managed.

What the operation involves¶

Your surgeon will make a single cut over the back of your finger joint. This open approach gives clear access to the area that needs treatment. Through this incision, your surgeon prepares the joint surfaces to ensure they can heal together firmly.

To hold the bones in place while they fuse, your surgeon uses a low-profile plate fixed to the bone. This plate sits close to the surface, which helps reduce irritation. In some cases, a headless compression screw is used instead. This screw fits inside the bone to provide strong stability without protruding into surrounding tissue. Your surgeon selects the fixation method based on what works best for your specific anatomy.

If you are having procedures on both the top and bottom joints of the same finger segment, your surgeon may use thin metal pins. These pins are chosen because they fit together easily without clashing. This coordination ensures both joints are treated safely in one session.

Once the bones are secured, your surgeon closes the cut with stitches or staples. A sterile dressing is applied to protect the site as you begin your recovery.

After the operation¶

You will wake up in the recovery ward with your hand elevated and protected in a dressing or splint. Most patients stay one night in hospital after this operation, though some are able to go home the same day. We provide pain relief to keep you comfortable. You must have someone stay with you for the first 24 hours to help you. Keep the dressing clean and dry. Do not drive while wearing the finger splint, as it prevents a safe grip on the wheel. You can drive once the splint comes off and your surgeon clears you. See Driving after upper-limb surgery for more details.

Recovery¶

You will notice swelling and stiffness in your finger during the first few weeks. This is normal. Your surgeon will guide you on managing this discomfort with rest and elevation. As the swelling settles, you will begin gentle movements to keep the joint flexible. We use a splint to protect the finger while it heals. You must keep this splint on as directed.

Hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. Our team will teach you simple exercises to restore motion and strength. You will start these once your surgeon clears you. Early movement helps prevent stiffness and supports a smoother recovery. You will learn how to use your hand for daily tasks without straining the healing finger.

You can return to light home activities as comfort allows. Avoid heavy gripping or lifting until your surgeon gives the go-ahead. Driving requires a firm grip on the wheel. You cannot drive while wearing a finger splint if it limits your control. Once the splint comes off and your surgeon clears you, you may resume driving. See our guide on Driving after upper-limb surgery for more details.

Your timeline may differ from others. Recovery depends on how your body heals and your specific needs. Your surgeon and physiotherapist will guide you through each stage. We are here to support you until you feel confident using your hand again.

What can go wrong¶

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

If your finger feels unusually stiff or tight, it may be a sign that the joint is not moving as expected. This stiffness can limit your ability to bend or straighten the tip of your finger. Let your surgeon know during your follow-up visits so they can check your progress.

You might notice redness, warmth, or swelling around the incision site. These signs can indicate an infection in the skin or deeper tissues. If you see pus draining from the wound or feel a fever, contact the clinic immediately. Early treatment helps prevent the infection from spreading.

Some patients report a clicking, grinding, or popping sensation in the finger. This feeling often means the bones are not fusing together solidly. This is called a nonunion. If you hear or feel this noise while moving your finger, tell your surgeon. They may need to take new X-rays to see how the bones are healing.

Pain that does not go away with simple painkillers can be a sign of trouble. This could be due to the hardware (the screw or plate) irritating the skin or tendons. If the metal feels like it is poking under your skin or causes sharp pain when you touch it, let us know. We can assess whether the hardware needs to be removed after the bone has healed.

In rare cases, the finger may not heal in the correct position. You might notice that the tip of your finger looks crooked or does not align with the rest of your hand. This can affect how your hand looks and functions. Discuss any concerns about the appearance or alignment of your finger with your surgeon.

The complications table on this page lists typical rates if you want the specifics.

When to call us¶

Call us if you have a fever, increasing redness or discharge from your wound, or sudden severe pain. Go to emergency if you notice calf swelling, shortness of breath, loss of sensation, or cannot move your limb. These signs need urgent assessment. We want to ensure your recovery stays on track and your hand heals safely.

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