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PIP Joint Fusion

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PIP joint fusion stabilizes a severely damaged middle finger joint, relieving pain when other treatments fail.

Updated May 2026

A hand-drawn illustration of surgical fusion of the middle-finger joint. — X-ray after a PIP joint fusion: a single compression screw locks the middle joint of the finger at a comfortable angle. The bones knit together over six to eight weeks, removing pain from a worn-out joint. 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 offer this procedure when non-operative care has not given enough improvement. You reach our clinic by GP or physiotherapist referral. A clinic assessment establishes the diagnosis. For degenerative or long-standing problems we usually try activity change, hand therapy, splinting, and injections first. Surgery follows when those have not helped.

Your surgeon may suggest this operation to relieve pain and restore stability in your finger joint. It is typically offered for severe wear-and-tear arthritis or after failed previous joint replacements. The goal is to stop the painful motion and provide a solid, stable finger for daily tasks. While some patients return to work after a median of 8 weeks, the primary aim is lasting pain relief and functional stability.

Before the operation¶

Please fast for six hours before your surgery and arrange a lift home. Bring a list of your current medications. Your surgeon will advise you on which medicines to pause beforehand. You may need X-rays, blood tests, or an anaesthetic review to ensure you are fit for the procedure. These checks help us plan your care safely. We use a single conventional incision over the finger to access the joint. This open approach allows clear visibility for the fusion. Please wear comfortable, loose clothing on the day. Follow all specific instructions from our team to prepare your body and mind for a smooth recovery.

On the day¶

You will arrive at the hospital for your admission. You will meet your anaesthetist to discuss your care plan. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.

You will then be taken into the operating theatre. Your surgeon performs this procedure using an open approach with a single conventional incision over the operative site. This allows direct access to the joint for the necessary reconstruction. Once the procedure is complete, you will wake up in our recovery area. Our team will monitor your comfort and stability before you prepare for discharge or further care.

What the operation involves¶

Your surgeon makes a single cut over the joint to access the area. This open approach allows clear visibility of the structures inside your finger. The specific steps depend on the type of procedure needed for your condition.

If you are having a joint replacement, your surgeon removes the worn-out surfaces of the bone. These are replaced with metal and plastic parts to restore movement. In some cases, a partial replacement using a carbon material may be used instead. If fusion is required, the joint surfaces are prepared and held together with screws or wires to encourage the bones to grow into one solid piece.

For certain deformities, your surgeon may tighten or reposition a tendon to stabilize the joint. This helps correct the shape and function of your finger. When multiple joints in the same finger need treatment, your surgeon carefully plans the placement of hardware to avoid parts getting in each other’s way.

Once the work inside is complete, your surgeon closes the cut with stitches or staples. A dressing is applied to protect the site as it begins to heal.

After the operation¶

You will wake up in the recovery ward. We manage your pain with standard medication. Your hand will be wrapped in a clean dressing and supported in a splint or brace. Most patients stay one night in hospital after this operation, though some are able to go home the same day. Please ensure someone stays with you for the first 24 hours to help you. Do not drive while wearing the splint, as it prevents a safe grip on the wheel. You can drive again once the splint comes off and your surgeon clears you. Learn more at Driving after upper-limb surgery.

Recovery¶

You will have a splint on your finger for several weeks. This protects the joint while it heals. Do not drive while wearing the splint if it stops you from holding the wheel safely. We will guide you on when it is safe to drive again. Read more about Driving after upper-limb surgery.

Expect some pain and swelling in the first few days. This is normal. Your surgeon will prescribe medication to help you stay comfortable. Keep your hand raised above your heart level as much as possible. This helps reduce swelling and eases discomfort.

You will start gentle movement exercises once your surgeon clears you. Hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. Your therapist will show you simple exercises to keep the surrounding tissues flexible. You will wear your splint during daily activities but remove it for these exercises.

As swelling settles and movement returns, you will gradually use your hand more. You can perform light tasks like eating or typing when comfortable. Avoid heavy lifting or gripping until your surgeon says it is safe. Your timeline may differ; your surgeon and physio will guide you.

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 you are having a joint replacement, the most common reason for needing another surgery is trouble with the tendons that straighten your finger. You might notice your finger feels weak or cannot lift properly. This happens because the extensor mechanism is not working as it should. If you see this change, tell your surgeon right away.

Nonunion means the bones do not knit together after a fusion surgery. You might feel persistent pain or notice that the joint still moves when it should be still. This risk is generally low, but it is important to report any ongoing pain or movement at the joint site during your follow-up visits.

If a fusion is needed later because a previous replacement did not work, the results can be fair to good, but complications are more likely. You might experience more pain or swelling than expected. Your surgeon will discuss these risks with you before deciding on this salvage procedure.

Younger patients often face a higher chance of needing revision surgery after a joint replacement, especially if the original problem was caused by an injury. This does not mean you will have problems, but it is a factor your surgeon considers when planning your care.

Revision joint replacements have a lower survival rate over five years compared to first-time surgeries. This means there is a higher chance of needing further treatment. If you have had previous hand surgeries, your surgeon will explain what this means for your specific case.

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 wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling, shortness of breath, loss of sensation, or inability to move your hand. We want to catch any issues early to keep your recovery on track.

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