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DIP joint fusion

Surgeon-side topic for dip joint fusion. Backed by 431 articles from the corpus, retrieved via combined MeSH + title-text matching.

63 citationsUpdated Sep 2026
Illustration: DIP joint fusion

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Distal interphalangeal (DIP) joint arthrodesis is a therapeutic procedure for the fingers that can be performed safely using low-profile plate fixation through a dorsal approach [3]. Various surgical techniques are available, including a lateral approach with plate fixation, which yields results equivalent to traditional methods but with fewer major complications [1]. The Herbert headless compression screw provides an acceptable rate of union and ease of operative technique [6], while the “Pepper-Pot” arthrodesis technique is easy to perform, maintains digital length, and allows fine-tuning of the arthrodesis position with fusion rates comparable to previously described techniques [9]. When more volar joint preparation and volar implant insertion sites are necessary, the smile incision and reverse shotgun approach serves as a surgical option [2]. Satisfactory results in interphalangeal joint arthrodesis can be achieved with proper patient selection, meticulous technique, and fusion in an appropriate position for the patient's activities and expectations [17].

Outcomes are generally favorable for therapeutic surgeries like arthrodesis, though further study is required to determine the best indications for ulnar head arthroplasty [158]. The rate of fusion using a headless compression screw for DIP joint arthrodesis compares favorably with prior series using other methods of fixation [72]. However, caution is required when using headless compression screws to avoid problems related to screw prominence in the narrow aspects of the distal and middle phalanges [12]. Care must be taken in selecting implants for distal interphalangeal joint arthrodesis, and alternative fixation techniques may be required [27]. Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving a range of movement of 30–40 degrees with a low overall complication rate of 5% [4].

Patients prefer surgical attributes characteristic of arthroplasty, such as the ability to preserve joint motion and grip strength, relative to those associated with arthrodesis, such as decreased need for reoperation, lower costs, and shorter reoperation times [164]. Combining DIP arthrodesis with PIP Swanson arthroplasty results in a favourable outcome regarding simultaneous bony union and flexibility [7], and combining proximal interphalangeal joint arthroplasty with distal interphalangeal arthrodesis leads to 1-year outcomes similar to those achieved by proximal interphalangeal joint replacement alone [8]. Arthrodesis as a salvage for failed proximal interphalangeal joint arthroplasty demonstrates fair to good subjective and functional outcomes, although solid fusion is not completely reliable or without complication [13]. Ultimate salvage for a failed PIP joint arthroplasty may require arthrodesis or even amputation [16]. Prosthetic replacement of digital joints in the rheumatoid hand is a reasonable and better alternative than either fusion or arthroplasty [39].

Anatomy & Pathophysiology

Bony Anatomy

The hand skeleton comprises 27 bones, 19 of which are long bones [46]. It is organized into five rays, each forming a polyarticulated chain of metacarpals and phalanges [46]. The thumb ray consists of a metacarpal and two phalanges, while the four finger rays each consist of a metacarpal and three phalanges [46]. Epiphyseal plate locations vary by bone: the phalanges and first metacarpal have proximal epiphyseal plates, whereas the other metacarpals have distal epiphyseal plates [46]. The transverse palmar axis is oblique, forming an acute angle of approximately 75 degrees with the longitudinal axis [46].

Extensor Mechanism

DIP joint extension is achieved through conjoined lateral bands composed of tendinous slips from extrinsic and intrinsic tendons [45]. The principal bony insertion of the extrinsic digital extensors is on the dorsal proximal aspect of the middle phalanx [45]. The deep head of each dorsal interosseous muscle forms a lateral tendon, or lateral band, at the level of the metacarpophalangeal joint [80]. These lateral bands are joined by the lateral slips of the extensor tendon to form the conjoined lateral band [80]. The two conjoined lateral bands to each finger unite at the distal third of the middle phalanx to form the terminal tendon, which inserts at the base of the distal phalanx to extend it [80].

Boutonnière deformities primarily arise at the PIP joint when stretching of the extensor tendon over the joint induces hyperextension of the DIP and MCP joints [98]. This deformity is caused by synovitis at the PIP joint, elongation of the central slip, lateral band subluxation below the PIP joint axis of rotation, and shortening of the retinacular ligaments [98]. Swan neck deformities can occur at the DIP, PIP, and MCP joints as a result of multiple etiologies [94]. Specifically, synovitis at the PIP joint causes stretching of the volar plate and the flexor digitorum superficialis, inducing an extension deformity in the PIP joint [94]. A pseudoboutonniere deformity is characterized by a flexion contracture of the PIP joint following a traumatic PIP joint hyperextension injury to the volar plate and checkrein ligaments [138]. In pseudoboutonniere deformity, the terminal tendon and DIP joint are not involved, and there is no pathologic tensioning of the terminal tendon [138].

Flexor Mechanism

The flexor digitorum profundus inserts on the proximal volar aspect of the distal phalanx [45]. It flexes the distal interphalangeal joint as well as the proximal interphalangeal and metacarpophalangeal joints [45]. The flexor digitorum superficialis inserts via radial and ulnar slips into the proximal metaphysis of the middle phalanx [86]. Its primary function is digital flexion at the proximal interphalangeal joint [86]. The A5 annular pulley is located over the distal interphalangeal joint [86].

Soft Tissue & Vascular Anatomy

The dorsal covering of the interphalangeal articulations forms a unique cutaneous unit characterized by a considerable excess of skin when the digits are in extension [79]. The dorsal integument of the distal phalanx is distinct due to the nail bed with its matrix [79]. The dorsal skin is thin and possesses loose connections with deeper planes, allowing free gliding and full flexion at the digital joints [88]. Flexion of the fingers produces a significant lengthening of the dorsal skin, with an average increase of 3 cm in the middle finger from extension to full flexion [88]. The dorsal subdermal arterial network provides consistent and symmetrical perfusion to the dorsal surface of the PIP joint [64]. The nail's germinal matrix begins a few millimeters distal to the DIP joint line [95].

Pathophysiology & Functional Impact

The majority of patients who underwent arthrodesis for small hand joint pyarthrosis had involvement of the DIP joint [19]. Penetrating joint injury was the most common cause of septic arthritis in small hand joints, occurring in 73 of 110 patients [19]. DIP joint fusion is an established method to treat destroyed, painful, and unstable DIP joints and correct fixed joint deformities, including the swan neck type [95]. DIP arthrodesis is generally well tolerated, especially if there is a mobile PIP and MCP joint [95]. However, even with a successful DIP fusion, the fine motor skills of a finger may be compromised [95].

The morbidity of DIP arthrodesis includes nonunion, malunion, and infection [95]. Stern and Fulton reported a 20% complication rate for DIP arthrodesis, with the majority of problems related to the fixation method and hardware used [95]. In general, distal interphalangeal fusion of the digits is tolerated well with limited loss of function [99]. PIP joint motion is considered much more important to preserve than DIP joint motion [99]. Fingers with fused PIP joints are of little use for grip or grasp and frequently get in the way because they do not follow the normal arc of the other fingers [99]. The MCP joint contributes 77% of the total arc of finger flexion [99]. Studies have shown that as little as 5 to 10 degrees of flexion and 30 to 35 degrees of extension are needed for most activities of daily living [99]. The patterns of peri-articular finger injuries differ greatly between the three finger joints, explained by the mechanism of falling and local biomechanical forces [92].

Classification

Nalebuff: This system classifies boutonniere deformity into three stages based on the passive correctability of the PIP joint flexion deformity and the condition of the PIP joint articular surfaces [71]. Stage 1 is characterized by synovitis of the PIP joint and a slight, fully correctable extensor lag [71]. Stage 2 consists of a marked flexion deformity of the PIP joint [71]. The deformity itself is defined by a flexion posture of the PIP joint and a hyperextension posture of the DIP joint, and may present as either flexible or fixed [71].

Wehbe and Schneider: This classification is used for staging bony mallet finger injuries [167]. Type II injuries are characterized by DIP joint subluxation [167]. Subtypes B and C involve a bony mallet finger that includes at least one-third of the DIP joint surface [167].

Larsen: This classification is used to grade radiographic findings in rheumatoid arthritis [76].

Green: This classification is used for grading trigger digit severity [169].

Other Considerations: Subluxation of the DIP joint is defined as palmar displacement of the distal phalanx greater than 7% of the length of the distal phalangeal articular surface [166].

Clinical Presentation

Osteoarthritis

Inspection of the osteoarthritic distal interphalangeal (DIP) joint is heralded by the presence of Heberden nodes, which signifies swelling and periarticular osteophyte formation [101]. Mucous cyst formation may occur in relation to an osteoarthritic DIP joint [101]. Palpation of the acutely inflamed osteoarthritic DIP joint elicits tenderness as well as a sensation of fullness about the joint with loss of the normal bony contour [101]. The range of motion of the osteoarthritic DIP joint may be limited due to a superimposed flexion contracture [101]. Normal DIP joint range of motion is 0 to 60 degrees [101]. In erosive or inflammatory osteoarthritis, the DIP joint is the most commonly affected joint [101]. Radiological osteoarthritis after a mallet finger fracture is accompanied by a decrease in range of motion of the DIP joint [24].

Trauma and Deformity

Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity [23]. A patient with a flexor digitorum profundus (FDP) avulsion injury presents with an inability to actively flex the DIP joint [115]. Ecchymosis, pain, and swelling of the involved finger are common findings in FDP avulsion injuries, though these signs may be relatively absent [115]. Pseudo boutonniere deformity can be identical in appearance to boutonniere deformity and is usually seen late after having been progressively present for several weeks or more [51]. This deformity is caused by volar flexor tendon injury, usually PIP joint volar plate injury or flexor tendon pulley disruption that causes gradual flexion contracture along the tendon sheath [51]. In pseudo boutonniere deformity, the DIP joint is often no longer supple and is indistinguishable from a boutonniere deformity [51]. A positive Boyes Test occurs when the lateral bands become adherent laterally and restrict passive and active distal interphalangeal (DIP) joint flexion when the proximal interphalangeal (PIP) joint is maximally extended but flexes easily when the PIP joint is flexed [51]. The swan neck deformity can progress significantly with time because of increasing DIP joint flexion contracture [58].

Infection

Patients with small hand joint pyarthrosis tended not to present to their primary care provider on the day of injury but rather when the signs and symptoms of infection started, which was an average of 5 days later [19].

Investigations

Plain radiography: Orthogonal plain radiographs are the standard modality for assessing union in hand and wrist arthrodesis procedures, including the distal interphalangeal joint, rather than advanced imaging such as computed tomography or magnetic resonance imaging [21]. Radiographic union is defined by the appearance of trabeculae crossing the arthrodesis site on at least 2 of 4 cortices [21]. Cases that fail to demonstrate this union across the arthrodesis site by 90 days after surgery are classified as delayed unions [21]. The absence of definitive union after 90 days typically warrants additional patient follow-up [21].

Other Considerations: Radiological osteoarthritis following mallet finger fractures is accompanied by a decrease in range of motion of the distal interphalangeal joint [24]. However, this decrease in range of motion does not clinically affect patient-reported outcomes [24].

Treatment

Non-Operative

The provided evidence does not detail specific conservative management protocols such as weight loss, physical therapy, NSAIDs, or injections for DIP joint fusion.

Operative

Indications: Satisfactory results for interphalangeal joint arthrodesis are achieved through proper patient selection, meticulous technique, and positioning the joint fusion appropriately for the patient's activities and expectations [17]. Diabetes and surgeon experience are identified factors that increase the risk of postoperative complications in DIP or thumb IP joint arthrodeses [20].

Surgical Approach / Technique: DIP joint fusion of the fingers or IP joint fusion of the thumb can be performed safely with low-profile plate fixation through a dorsal approach [3]. The "pepper-pot" arthrodesis technique is easy to perform, maintains digital length, and allows fine-tuning of the arthrodesis position, with fusion rates comparable to previously described techniques [9]. A new DIP joint arthrodesis technique is simple and reliable, providing consistent clinical results with a very low non-union rate and an acceptable complication rate [73]. The bone compression technique for arthrodesis is useful in complicated cases and reports a fusion rate comparable to other studies despite high clinical complexity [28]. In the ischemic hand with systemic scleroderma, dorsal bipedicle flaps vascularized by the dorsal cutaneous artery network are the preferred approach for PIP joint arthrodesis [64].

Implant Selection: The Acultrak fusion screw is a feasible and adequate tool for DIP arthrodesis, particularly in Korean patients [26]. Care must be taken in selecting implants for DIP joint arthrodesis, and alternative fixation techniques may be required due to dimensional constraints [27]. The Reverse Fix Nail is a favorable implant for DIP joint or thumb IP joint arthrodesis with a comparable bone union rate and lower risk of hardware prominence than other implants [144]. K-wires offer the easiest compatibility for combined DIP arthrodesis and PIP procedures regarding hardware conflict [11]. K-wires alone for small joint arthrodesis have a reported nonunion rate of 0.6% [65]. However, K-wires at the DIP joint are frequently a nuisance due to catching on clothing, infection, backing out, or falling out [65]. A 20% complication rate for K-wire fixation at the DIP joint has been reported, including hardware protrusion, migration, loosening, failure to achieve union, pin track infections, and stiffness [65]. Buried hardware for DIP arthrodesis avoids complications associated with external pins such as protrusion and infection [65]. The Herbert screw is preferred over newer cannulated screws by some surgeons because it is less expensive, equally easy to insert, and allows manual compression after placement [65].

Combined Procedures and Alternatives: 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% [4]. The combination of DIP arthrodesis and PIP Swanson arthroplasty results in a favourable outcome in terms of simultaneous bony union and flexibility [7]. Combining proximal interphalangeal joint arthroplasty with distal interphalangeal arthrodesis leads to 1-year outcomes that are similar to those achieved by proximal interphalangeal joint replacement alone [8]. Prosthetic replacement of digital joints in the rheumatoid hand is described as a reasonable and better alternative than either fusion or arthroplasty [39].

Other Considerations: The PIP joint arthrodesis angle affects DIP joint extension [22]. Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity, and open reduction and internal fixation is a viable treatment option for chronic cases, though osteoarthritis may develop [23].

Revision: In revision surgery for failed DIP arthrodesis with a retained headless screw, the previous dorsal scar is reincorporated and extended proximally to expose the nonunion [153]. In a case of failed DIP arthrodesis with a retained headless screw, progressive bone loss and absorption at the arthrodesis site and in the proximal aspect of the distal phalanx can occur [153].

Complications

General Outcomes and Risk Factors: DIP joint arthrodesis is frequently associated with complications [32]. Postoperative risk is elevated in patients with diabetes and is inversely related to surgeon experience [20]. Achieving satisfactory results requires proper patient selection, meticulous technique, and fusion in a position appropriate for the patient’s activities and expectations [17]. Cautious patient selection and consideration of potential complications are crucial for good outcomes in arthrodesis procedures [172].

Nonunion and Union: The Herbert headless compression screw provides an acceptable rate of union for DIP joint arthrodesis [6]. A 2007 study described a new technique demonstrating a very low non-union rate [73]. In a 2014 series, the fusion rate using headless compression screws for DIP and thumb IP joints compared favorably with prior series using other fixation methods [72]. All cases in a 2026 percutaneous reamed arthrodesis series for DIP arthritis achieved union at a median of 6 weeks [181]. The combination of DIP arthrodesis and PIP Swanson arthroplasty resulted in favorable outcomes regarding simultaneous bony union [7]. In a 2002 study, the bone compression technique for arthrodesis and nonunion in the hand reported a fusion rate comparable to other studies despite high clinical complexity [28]. In a 2011 series of 131 DIP joints treated with silicone interpositional arthroplasty, the overall complication rate was 5% [4].

Hardware and Implant Complications: Hardware complications were common in wrist arthrodesis for cerebral palsy, leading authors to routinely recommend hardware removal [179]. In total wrist arthrodesis, complications and reoperations occur frequently, most often due to incomplete bone fusion or hardware-related problems [30]. The most common reason for reoperation after 4-corner arthrodesis was implant removal [180]. In thumb metacarpophalangeal arthrodesis, screw fixation has fewer hardware complications and a lower reoperation rate than tension band arthrodesis [184]. In a 2008 series, the lateral approach and plate fixation for DIP arthrodesis resulted in fewer major complications compared to traditional methods [1].

Infection and Specific Pathologies: In a 2011 series of 110 patients with small hand joint pyarthrosis, the majority of patients who underwent arthrodesis had involvement of the DIP joint [19]. Penetrating joint injury was the most common cause of septic arthritis in a 2011 series of small hand joint pyarthrosis, occurring in 73 patients [19]. In a 2017 review of 78 patients undergoing DIP cheilectomy, no postoperative infections or other complications were noted [56].

Malunion and Functional Deficits: In PIP fusion, the most common complications are nonunion and malunion [157]. Malunion in PIP fusion can be functionally disabling, particularly regarding coordination with other fingers, and includes malrotation and lateral deviation [157]. Non-union in PIP fusion may be due to biological factors such as difficult bone conditions or technical problems with bone fixation [157]. In a 2011 series of 131 DIP joints treated with silicone interpositional arthroplasty, the procedure achieved a range of movement of 30–40 degrees [4]. In a 2023 study, combining PIP joint arthroplasty with DIP arthrodesis led to 1-year outcomes similar to those achieved by PIP joint replacement alone [8]. In a 2020 comparative study, PIP joints with concomitant DIP arthrodesis had a postoperative mean flexion of 80.8 degrees and a mean arc of 69.2 degrees, which were significantly higher than those without DIP arthrodesis [110].

Recovery

Light activity (weeks): The provided evidence does not specify a typical week range for the resumption of desk work, driving, or light activities of daily living.

Full activity (months): The provided evidence does not specify a month range for the return to manual work, sport, or full range of motion and strength.

Complete recovery / outcome plateau (months): The provided evidence does not specify a month range for the stabilization of pain, strength, and final functional outcomes.

Rehabilitation protocol: Sustained active exercise appears to support DIP joint extension recovery [108].

Functional milestones: Satisfactory results in DIP joint fusion can be achieved with proper patient selection, meticulous technique, and joint fusion in an appropriate position for the patient's activities and expectations [17]. Radiological osteoarthritis after a mallet finger fracture is accompanied by a decrease in range of motion of the DIP joint, which does not clinically affect patient-reported outcomes [24].

Other Considerations: The lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods but with fewer major complications [1]. The dorsal approach with low-profile plate fixation allows DIP joint fusion of the fingers to be performed safely [3]. The smile incision and reverse shotgun approach is a surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary [2]. Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving a range of movement of 30–40 degrees [4]. Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [4].

Key Evidence

  • [L4] The results obtained in this small series are equivalent to the traditional methods of DIP joint arthrodesis but with fewer major complications. [1] (10.1016/j.jhsa.2007.09.004)
  • [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. [2] (10.1186/s12891-024-08016-6)
  • [L4] An IP joint fusion of the thumb or DIP joint fusion of the fingers can be performed safely with a low-profile plate fixation through a dorsal approach. [3] (10.1016/j.jhsa.2018.03.049)
  • [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%. [4] (10.1177/1753193411422679)
  • [L4] The Herbert screw provides an acceptable rate of union and ease of operative technique, making it a suitable procedure for DIP joint arthrodesis. [6] (10.1007/s11552-010-9295-3)
  • [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)
  • [L3] Combining proximal interphalangeal joint arthroplasty with distal interphalangeal arthrodesis leads to 1-year outcomes that are similar to those achieved by proximal interphalangeal joint replacement alone. [8] (10.1177/17531934231191255)
  • [L4] The technique is easy to perform, maintains digital length, and allows the surgeon to fine-tune the position of arthrodesis, with fusion rates comparable to previously described techniques. [9] (10.1054/jhsb.2002.0798)
  • [L5] Combined DIP arthrodesis and PIP procedures present unique challenges regarding hardware conflict; K-wires offer the easiest compatibility, while headless screws must ideally not reach proximal to the midpoint of the middle phalanx. [11] (10.1016/j.jhsa.2024.08.006)
  • [L4] Caution must be used when considering these screws for DIP joint arthrodesis, to avoid problems related to screw prominence in the narrow aspects of the distal and middle phalanges. [12] (10.1016/j.jhsa.2014.02.007)
  • [L4] Although achieving solid fusion with arthrodesis is not completely reliable or without complication, patients' subjective and functional outcomes demonstrate fair to good results. [13] (10.1016/j.jhsa.2010.10.030)
  • [L5] Ultimate salvage for the failed PIP joint arthroplasty may require arthrodesis or even amputation. [16] (10.1016/j.hcl.2017.12.011)
  • [L5] Satisfactory results can be achieved with proper patient selection, meticulous technique, and joint fusion in an appropriate position for the patient's activities and expectations. [17] (10.5435/jaaos-d-15-00033)
  • [L3] [19] (10.1016/j.jhsa.2011.05.022)
  • [L3] Diabetes and surgeon experience were identified as factors increasing the risk of postoperative complications in these DIP/thumb IP joint arthrodeses. [20] (10.1186/s12891-024-07361-w)
  • [L2] [21] (10.1016/j.jhsa.2022.05.016)
  • [L5] The PIP joint arthrodesis angle affects DIP joint extension. [22] (10.1016/j.jhsa.2017.04.002)
  • [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. [23] (10.1016/j.jhsa.2010.05.025)
  • [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. [24] (10.1016/j.jhsa.2023.03.027)
  • [L4] The acutrak fusion screw is a feasible and adequate tool for DIP arthrodesis, particularly in Koreans. [26] (10.1007/s00402-011-1413-3)
  • [L4] Care must be taken in selecting implants for distal interphalangeal joint arthrodesis, and alternative fixation techniques may be required. [27] (10.1007/s11552-014-9679-x)
  • [L4] The authors found the technique useful, especially in complicated cases, and reported a fusion rate comparable to other studies despite the high clinical complexity of the patient population. [28] (10.1054/jhsb.2002.0795)
  • [L5] Complications and reoperations occur frequently, most often due to incomplete bone fusion or hardware-related problems, and it remains unknown which implant type is best or if the carpometacarpal joint should be included. [30] (10.1177/17531934241295343)
  • [L3] Arthrodesis of the distal interphalangeal joint often leads to complications. [32] (10.1177/17531934221111641)
  • [L4] [51] (10.1016/j.jht.2023.02.005)
  • [L4] [56] (10.1016/j.jhsa.2017.07.006)
  • [L5] The swan neck deformity in this individual progressed significantly with time because of increasing DIPJ flexion contracture. [58] (10.1016/j.jht.2009.11.005)
  • [L4] [64] (10.1016/j.jhsa.2018.03.008)
  • [L4] [65] (10.1016/j.hcl.2006.02.015)
  • [L5] [71] (10.5435/00124635-199903000-00002)
  • [L4] Our rate of fusion compares favorably with prior series using other methods of fixation. [72] (10.1016/j.jhsa.2013.09.040)
  • [L4] The technique is simple and reliable giving consistent clinical results with a very low non-union rate and an acceptable complication rate. [73] (10.1007/s00402-007-0457-x)
  • [L4] [76] (10.1016/j.jhsa.2013.05.007)
  • [L4] The patterns of peri-articular finger injuries differ greatly between the three finger joints, explained by the mechanism of falling and local biomechanical forces. [92] (10.1177/17531934251381203)
  • [L2] Sustained active exercise appears to support DIP joint extension recovery. [108] (10.1016/j.jhsa.2024.12.011)
  • [L4] [110] (10.1177/1753193420954371)
  • [L5] [115] (10.1097/01.blo.0000205903.51727.62)
  • [L5] [138] (10.1016/j.jhsa.2022.10.019)
  • [L4] The Reverse Fix Nail is a favorable implant for DIP joint or thumb IP joint arthrodesis with a comparable bone union rate and lower risk of hardware prominence than other implants. [144] (10.1016/j.jhsa.2013.01.017)
  • [L4] [153] (10.1016/j.jhsa.2013.04.018)
  • [L5] [157] (10.1302/2058-5241.4.180042)
  • [L5] While outcomes are generally favorable for therapeutic surgeries like arthrodesis and arthroplasty, further study is required to determine the best indications for ulnar head arthroplasty. [158] (10.1016/j.jht.2013.12.002)
  • [L3] In aggregate, patients prefer surgical attributes characteristic of arthroplasty (ability to preserve joint motion and grip strength) relative to those associated with arthrodesis (decreased need for reoperation, lower costs, and shorter reoperation times). [164] (10.1016/j.jhsa.2018.03.001)
  • [L2] [166] (10.1177/1753193414554556)
  • [L1] [167] (10.1177/1753193420917567)
  • [L1] [169] (10.1016/j.jht.2018.02.007)
  • [L4] Cautious patient selection and consideration of potential complications are crucial for good outcomes. [172] (10.1177/17531934231205548)
  • [L4] Hardware complications were common, and consequently, the authors now routinely recommend hardware removal. [179] (10.1016/j.jhsa.2009.03.006)
  • [L3] The most common reason for reoperation after 4-corner arthrodesis was implant removal. [180] (10.1016/j.jhsg.2022.10.015)
  • [L4] All cases achieved union at a median of 6 weeks. [181] (10.1177/17531934251409628)
  • [L4] Our data suggest that screw fixation has fewer hardware complications and a lower reoperation rate than tension band arthrodesis. [184] (10.1016/j.jhsa.2023.11.024)

See Also

References

[1] 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

[2] Smile incision and reverse shotgun approach in distal interphalangeal joint arthrodesis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-08016-6

[3] Dorsal Plate Fixation for Distal Interphalangeal Joint Arthrodesis of the Fingers and Thumb. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.03.049

[4] Joint replacement in 131 painful osteoarthritic and post-traumatic distal interphalangeal joints. Journal of Hand Surgery (European Volume). 2011. DOI: 10.1177/1753193411422679

[6] Distal Interphalangeal Joint Arthrodesis with the Herbert Headless Compression Screw: Outcomes and Complications in 64 Consecutively Treated Joints. HAND. 2010. DOI: 10.1007/s11552-010-9295-3

[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] 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

[9] “Pepper-Pot” Arthrodesis of the Small Joints of the Hand: Our Experience in 68 Cases. Journal of Hand Surgery. 2002. DOI: 10.1054/jhsb.2002.0798

[11] Combined Distal Interphalangeal Joint Arthrodesis With Proximal Interphalangeal Joint Arthroplasty or Arthrodesis: Technical Considerations. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.08.006

[12] 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

[13] Arthrodesis as a Salvage for Failed Proximal Interphalangeal Joint Arthroplasty. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.10.030

[16] Salvaging a Failed Proximal Interphalangeal Joint Implant. Hand Clinics. 2018. DOI: 10.1016/j.hcl.2017.12.011

[17] Arthrodesis of the Metacarpophalangeal and Interphalangeal Joints of the Hand. Journal of the American Academy of Orthopaedic Surgeons. 2016. DOI: 10.5435/jaaos-d-15-00033

[19] Pyarthrosis of the Small Joints of the Hand Resulting in Arthrodesis or Amputation. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.05.022

[20] 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

[21] The Impact of Smoking on Delayed Osseous Union After Arthrodesis Procedures in the Hand and Wrist. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.05.016

[22] Biomechanics and Pinch Force of the Index Finger Under Simulated Proximal Interphalangeal Arthrodesis. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.04.002

[23] Floating Distal Interphalangeal Joint Injury: Case Report. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.05.025

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