Skip to main content
Log in

A Systematic Review of Distal Interphalangeal Joint Arthrodesis

  • Review Article
  • Published:
Journal of Hand and Microsurgery

Abstract

Arthrodesis of the distal interphalangeal joint of the hand is a reliable procedure for creating a painless stable joint. Numerous techniques are described within the literature for varying indications. We undertook a systematic review of all studies published within the English literature to provide a comparison of the different techniques. The published studies were predominantly of Level IV evidence. The most commonly employed techniques were Kirschner wire, headless compression screw and cerclage wires. There was no difference in infection rates. Headless compression screws appear to have increased union rates but are associated with complications not seen with other well-established and cheaper techniques. The screw diameter is often similar to or larger than the joint itself, which can result in penetration. Furthermore, they limit the available angle for achieving fusion. Other than in terms of union, there is insufficient evidence to show the headless compression screw is superior to other techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Moberg E, Henrickson B (1960) Technique for digital arthrodesis: a study of 150 cases. Acta Chir Scand 118:331–338

    CAS  PubMed  Google Scholar 

  2. Pribyl CR, Omer GR Jr, McGinty L (1996) Effectiveness of the chevron arthrodesis in small joints of the hand. J Hand Surg [Am] 21:1052–1058

    Article  CAS  Google Scholar 

  3. Carroll RE, Hill NA (1969) Small joint arthrodesis in hand reconstruction. J Bone Joint Surg 51:1219–1221

    CAS  PubMed  Google Scholar 

  4. Lewis RC, Nordyke MD, Tenny JR (1986) The tenon method of small joint arthrodesis in the hand. J Hand Surg [Am] 11:567–569

    Article  CAS  Google Scholar 

  5. Bunnel S (1948) Surgery of the hand, 2nd edn. J.B. Lippincott Co., Philadelphia

    Google Scholar 

  6. Von Saal FH (1953) Intramedullary fixation in fractures of the hand and finger. JBJS 35A:5

    Google Scholar 

  7. Tupper JW (1972) A compression arthrodesis device for small joints of the hands. Hand 4:62–64

    Article  CAS  PubMed  Google Scholar 

  8. Micks JE, Hager D (1970) A compression apparatus for fusion of the hand joints. Med Trial Tech 16:35–37

    CAS  Google Scholar 

  9. Weber BG (1964) Grundlagen und moglichkeiten der juggertungs osteosynthesis. Chirurgie 35:81

    CAS  Google Scholar 

  10. Muller G, Schoenberger F (1970) Technik der compression arthrodese am finger mittels jug shraube. Handchirurgie 2:218

    Google Scholar 

  11. Faithfull DK, Herbert TJ (1984) Small joint fusions of the hand using the Herbert bone screw. J Hand Surg (Br) 9:167–168

    Article  CAS  Google Scholar 

  12. Konan S, Das A, Taylor E, Sorene E (2013) Distal interphalangeal joint arthrodesis in extension using a headless compressive screw. Acta Ortho Belg 79:154–158

    Google Scholar 

  13. Song JH, Lee JY, Chung YG, Park IJ (2012) Distal interphalangeal joint arthrodesis with a headless compression screw: morphometric and functional analyses. Arch Orthop Trauma Surg 132:663–669. doi:10.1007/s00402-011-1413-3

    Article  PubMed  Google Scholar 

  14. Brutus JP, Palmer AK, Mosher JF, Harley BJ, Loftus JB (2006) Use of a headless compression screw for distal interphalangeal joint arthrodesis in digits: clinical outcome and review of complications. J Hand Surg 31A:85–89

    Article  Google Scholar 

  15. Iwamoto T, Matsumura N, Sato K, Momohara S, Toyama Y, Nakamura T (2013) An obliquely placed headless compression screw for distal interphalangeal joint arthrodesis. J Hand Surg [Am] 38A:2360–2364. doi:10.1016/j.jhsa.2013.09.026

    Article  Google Scholar 

  16. Cox C, Earp BE, Floyd WE, Blazar PE (2014) Arthrodesis of the thumb interphalangeal joint and finger distal interphalangeal joints with a headless compression screw. J Hand Surg [Am] 39:24–28. doi:10.1016/j.jhsa.2013.09.040

    Article  Google Scholar 

  17. Villani F, Uribe-Echevarria B, Vaienti L (2012) Distal interphalangeal joint arthrodesis for degenerative osteoarthritis with compression screw: results in 102 digits. J Hand Surg [Am] 37A:1330–1334. doi:10.1016/j.jhsa.2012.02.048

    Article  Google Scholar 

  18. Ruchelsman DE, Hazel A, Mudgal CS (2010) Treatment of symptomatic distal interphalangeal joint arthritis with percutaneous arthrodesis: a novel technique in select patients. Hand 5:434–439. doi:10.1007/s11552-010-9265-9

    Article  PubMed Central  PubMed  Google Scholar 

  19. Matsumoto T, Nakamura I, Miura A, Momoyama G, Ito K (2013) Distal interphalangeal joint arthrodesis with the reverse fix nail. J Hand Surg [Am] 38A:1301–1306. doi:10.1016/j.jhsa.2013.01.017

    Article  Google Scholar 

  20. El-Hadidi S, Al-Kdah H (2003) Distal interphalangeal joint arthrodesis with Herbert screw. Hand Surgery 8:21–24

    Article  PubMed  Google Scholar 

  21. Kocak E, Carruthers KH, Kobus RJ (2011) Distal interphalangeal joint arthrodesis with the Herbert headless compression screw: outcomes and complications in 64 consecutively treated joints. Hand 5:56–59. doi:10.1007/s11552-010-9295-3

    Article  Google Scholar 

  22. Lamas Gomez C, Proubasta I, Escriba I, Itarte J, Caceres E (2003) Distal interphalangeal joint arthrodesis: treatment with Herbert screw. J South Orth Ass 12:154–159

    CAS  Google Scholar 

  23. Stern PJ, Fulton DB (1992) Distal interphalangeal joint arthrodesis: an analysis of complications. J Hand Surg 17A:1139–1145

    Article  Google Scholar 

  24. Engel J, Tsur H, Farin I (1977) A comparison between K-wire and compression screw fixation after arthrodesis of the distal interphalangeal joint. Plast Recon Surg 60:611–614

    Article  CAS  Google Scholar 

  25. Burton RI, Margles SW, Lunseth PA (1986) Small-joint arthrodesis in the hand. J Hand Surg 11A:678–682

    Article  Google Scholar 

  26. Olivier LC, Gensigk F, Board TN, Kendoff D, Krehmeier U, Wolfhard U (2008) Arthrodesis of the distal interphalangeal joint: description of a new technique and clinical follow-up at 2 years. Arch Orthop Trauma Surg 128:307–311

    Article  CAS  PubMed  Google Scholar 

  27. Teoh LC, Yeo SJ, Singh I (1994) Interphalangeal joint arthrodesis with oblique placement of an AO lag screw. J Hand Surg 19B:208–211

    Article  Google Scholar 

  28. Mantovani G, Fukushima WY, Cho AB, Aita MA, Lino W, Nunes Faria F (2008) Alternative to the distal interphalangeal joint arthrodesis: lateral approach and plate fixation. J Hand Surg [Am] 33A:31–34. doi:10.1016/j.jhsa.2007.09.004

    Article  Google Scholar 

  29. Shanker HK, Johnstone AJ, Rizzo L, Chesney RB (2002) Pepper-pot arthrodesis of the small joints of the hand: our experience in 68 cases. J Hand Surg 27B:430–432

    Article  Google Scholar 

  30. Lister G (1978) Intraosseous wiring of the digital skeleton. J Hand Surg [Am] 5:427–435

    Article  Google Scholar 

  31. Stahl S, Rozen N (2001) Tension-band arthrodesis of the small joints of the hand. Orthopedics 24:981–983

    CAS  PubMed  Google Scholar 

  32. Zavitsanos G, Watkins F, Britton E, Somia N, Gupta A, Kleinert H (1999) Distal interphalangeal joint arthrodesis using intramedullary and interosseous fixation. Hand Surgery 4:51–55

    Article  PubMed  Google Scholar 

  33. Leonard MH, Capen DA (1979) Compression arthrodesis of finger joints. Clinc Orth Rel Res 145:193–198

    Google Scholar 

  34. Seitz WH Jr, Sellman DC, Scarcella JB, Froimson AI (1994) Compression arthrodesis of the small joints of the hand. Clin Orthop Rel Res 304:116–121

    Google Scholar 

  35. Wexler MR, Rousso M, Weinberg H (1977) Arthrodesis of finger joints by dynamic external compression. Plast Recon Surg 59:882–885

    Article  Google Scholar 

  36. Sabbagh W, Grobbelaar AO, Clarke C, Smith PJ, Harrison DH (2001) Long-term results of distal arthrodesis with the Harrison-Nicolle peg. J Hand Surg 26B:568–571

    Article  Google Scholar 

  37. Arata J, Ishikawa K, Soeda H, Kitayama T (2003) Arthrodesis of the distal interphalangeal joint using a bioabsorbable rod as an intramedullary nail. Scan J Plast Recon 37:228–231

    Article  Google Scholar 

  38. Harrison SH, Nicolle PV (1974) A new intramedullary bone peg for digital arthrodesis. Br J Plast Surg 27:240–241

    Article  CAS  PubMed  Google Scholar 

  39. Faran K, Ichioka N, Trzeciak MA, Han S, Medige J, Moy OJ (1999) Effect of bone quality on the forces generated by compressive screws. J Biomech 32:861–864

    Article  CAS  PubMed  Google Scholar 

  40. Mintalucci D, Lutsky KF, Matzon JL, Rivlin M, Niver G, Beredjiklian (2014) Distal interphalangeal joint bony dimensions related to headless compression screw sizes. J Hand Surg [Am] 39:1068–1074

    Article  Google Scholar 

  41. Wyrsch B, Dawson J, Weikert D, Milek M (1996) Distal interphalangeal joint arthrodesis comparing tension band wire and Herbert screw: a biomechanical and dimensional analysis. J Hand Surg [Am] 21A:438–443

    Article  Google Scholar 

  42. Hooper G (1987) Techniques of interphalangeal arthrodesis. In: Bowers WH (ed) The interphalangeal joints. Churchill Livingstone, UK, pp 174–180

    Google Scholar 

  43. Katzman SS, Gibeault JD, Dickson K, Thompson JD (1993) Use of a Herbert screw for interphalangeal joint arthrodesis. Clin Orth Rel Res 296:127–132

    Google Scholar 

  44. Straub LR (1959) The rheumatoid hand. Clinical Orthopaedics 15:127–139

    CAS  PubMed  Google Scholar 

  45. Tomaino MM (2006) Distal interphalangeal joint arthrodesis with screw fixation: why and how. Hand Clin 22:207–210

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. R. Dickson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dickson, D.R., Mehta, S.S., Nuttall, D. et al. A Systematic Review of Distal Interphalangeal Joint Arthrodesis. J Hand Microsurg 6, 74–84 (2014). https://doi.org/10.1007/s12593-014-0163-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12593-014-0163-1

Keywords

Navigation