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Arthrodesis interphalangeal joint fusion

Michel Chraim, Peter Bock, Hamza M Alrabai, Hans-Jörg Trnka
AIMS: This study was aimed to study the arthrodesis of the first metatarsophalangeal joint using an oblique interfragmentary lag screw and dorsal plate as an effective option for the treatment of hallux rigidus. Few researchers have studied the outcome of this surgical method over a long follow-up period. PATIENTS AND METHODS: We performed a retrospective review of 60 patients status post arthrodesis of the first metatarsophalangeal joint. The mean age was 68.5 years and average follow-up lasted for 47...
August 20, 2016: International Orthopaedics
Shane McGowan, Mirella Deisher, Kristofer S Matullo
BACKGROUND: A thumb interphalangeal (IP) joint arthrodesis is typically performed in 0° to 30° of flexion; most daily activities involve increased flexion at the IP joint to facilitate pinch and grip. This study evaluates the preferred thumb IP joint position with certain tasks of daily living to determine a more satisfactory angle. METHODS: Twenty-eight healthy volunteers were splinted at various degrees (0°, 15°, 30°, 45°, bilaterally) with thumb orthotics, leaving the tip free, to mimic various angles of IP fusion...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Stephanie K Rigot, Rafael Diaz-Garcia, Richard E Debski, John Fowler
BACKGROUND: The biomechanical performance of distal interphalangeal joint (DIPJ) fixation techniques in response to cyclic and load-to-failure bending loads is generally unknown. The purpose of this study is to assess the performance of 4 commonly used techniques for DIP arthrodesis. METHODS: Phalanges were fixed by one of the following techniques: (1) 2 parallel Kirschner wires (K-wires), (2) 1 longitudinal K-wire and 1 oblique K-wire, (3) an Acutrak® 2 Micro headless compression screw, or (4) 90-90 wiring...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
Richard M Jay, D Scot Malay, Adam S Landsman, Nathan Jennato, James Huish, Melissa Younger
We undertook a multicenter, parallel treatment arm, randomized controlled trial to compare the outcomes after surgery for the treatment of lesser digital hammertoe using either a Kirschner wire or a 2-piece intramedullary, stainless steel implant for fixation of the proximal interphalangeal joint. Our primary aim was to compare the incidence of arthrodesis and complications, and our secondary aim was to compare the subjective foot-related outcomes measured using the Bristol Foot Score and the Foot Function Index, stratified by fixation group...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
D K Meena, S Thalanki, S B Sharma
PURPOSE: To review the outcome of wide resection and wrist fusion through centralisation of the ulna for recurrent giant cell tumour (GCT) of the distal radius in 10 patients. METHODS: Records of 7 women and 3 men aged 25 to 40 years who underwent wide resection and wrist fusion through centralisation of the ulna for grade I (n=6) and grade II (n=4) recurrent GCT of the distal radius were reviewed. Functional outcome was evaluated using the modified Musculoskeletal Tumor Society scoring system...
April 2016: Journal of Orthopaedic Surgery
Steven Beldner, Daniel B Polatsch
Metacarpophalangeal arthrodesis and interphalangeal arthrodesis are excellent tools in the surgeon's armamentarium to restore function of the disabled hand. Typical indications for these procedures are pain, deformity, and/or stiffness. Arthrodesis is generally considered a salvage procedure to be used when other reconstructive procedures, such as arthroplasty, are not possible or would be associated with a high rate of complication or failure. To determine the most functional position for arthrodesis in each patient, the surgeon should preoperatively evaluate the compromised joint in the context of the disease process, determine the initial cause of the joint pathology, and assess the condition of the surrounding joints...
May 2016: Journal of the American Academy of Orthopaedic Surgeons
Christopher R Hood, Douglas K Blacklidge, Scott M Hoffman
UNLABELLED: Digital arthrodesis is one of the most common surgical procedures performed by the foot and ankle surgeon. The market offers a variety of devices available to the surgeon to accomplish solid, permanent, and safe fusion for the patient. However, with these new devices come high surgical costs, adding to the burden on the already strapped health care system. We offer a simple technique updating the way in which a Kirschner wire is utilized for interphalangeal digital arthrodesis that employs the benefits of the newer implantable devices at a fraction of the cost...
October 2016: Foot & Ankle Specialist
Attilio Basile, Francesco Albo, Alessio Giai Via
Hammertoe is one of the most common foot deformities. Arthrodesis or arthroplasty of the proximal interphalangeal joint using temporary Kirschner wire fixation is the most widespread method of surgical stabilization. However, this type of fixation is associated with some potential complications that can be obviated if percutaneous fixation is avoided. The purpose of the present study was to prospectively collect clinical and radiographic outcomes of operative correction of hammertoe deformity using a permanently implanted 1-piece intramedullary device...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
A-S Matheron, S Gouzou, S Collon, F Bodin, S Facca, P Liverneaux
UNLABELLED: The main complications in distal interphalangeal (DIP) fusion are non-union and hardware-related symptoms. The primary aim of this study was to show that joint preparation for DIP fusion is not necessary in cases of stage IV chondropathy. The secondary aim was to show that use of buried compression screws decreases the complication rate. This continuous retrospective study included two groups of DIP percutaneous arthrodesis procedures carried out with 1.8mm break-away compression screws: group 1 underwent joint preparation through a dorsal approach and group 2 underwent a percutaneous procedure without joint preparation...
June 2015: Chirurgie de la Main
Christopher E Gross, Chaoyong Bei, Tenaja Gay, Selene G Parekh
BACKGROUND: Various techniques have been described for arthrodesis of the first metatarsophalangeal (MTP) joint. The purpose of this study was to retrospectively review the results of fixation for the first MTP arthrodesis of patients treated using dome-shaped reamers to prepare the joint surfaces and a novel MTP Plate with PocketLock fixation. METHODS: Between July 2012 and November 2013, 16 feet in 16 patients were treated with a first MTP arthrodesis with a MTP Plate with PocketLock fixation...
December 2015: Foot & Ankle Specialist
T Ameline, V Bégot, L Ardouin, C Hulet, N Hanouz
Various indications exist for thumb interphalangeal and finger distal interphalangeal arthrodesis. Various fixation techniques (compression screws, tension band wiring, K-wires) have been described with fusion rates varying between 80 and 100%. The objective of this study was to evaluate the outcomes of interphalangeal arthrodesis using the X-Fuse(®) intramedullary implant in terms of fusion rate and fusion position. A continuous series of 38 arthrodesis procedures was reviewed retrospectively to determine the fusion rate and evaluate complications linked to this fixation technique...
April 2015: Chirurgie de la Main
Michael Darowish, Rodney Brenneman, Justin Bigger
BACKGROUND: Headless compression screws have been used for arthrodesis of the distal interphalangeal joint with good clinical results. However, some distal phalanges are too small, thus precluding their use, or increasing complication rates. METHODS: In order to validate our digital measurements, radiographs of five cadaveric hands were obtained. The distal phalanges of these fingers were measured using our institution's digital radiograph software. The cadavers were then dissected, and the actual phalanges were measured to confirm the accuracy of the digital measurements; 200 consecutive hand radiographs were then measured to obtain average width and heights of the narrowest measurements of the distal phalanx of each finger...
March 2015: Hand: Official Journal of the American Association for Hand Surgery
D R Dickson, S S Mehta, D Nuttall, C Y Ng
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...
December 2014: Journal of Hand and Microsurgery
John T Capo, Eitan Melamed, Benhoor Shamian, Scott R Hadley, Whitney Ng Lai, Kenny Gerszberg, Steven Rivero, Paolo Caravaggi
PURPOSE: To determine in a cadaver model which, among 5 fixation methods for proximal interphalangeal (PIP) joint arthrodesis, has the greatest stiffness. METHODS: Thirty-five cadaver digits were randomly assigned to 1 of 5 fixation groups: oblique K-wire with coronal intraosseous wiring, tension-band wire (TBW), dorsal plate, intramedullary linked screw (IMS), and 90/90 wiring (90/90W). Testing was done by applying bending moments to the PIP joint in the sagittal and frontal planes...
October 2014: Journal of Hand Surgery
H Waizy, M Abbara-Czardybon
OBJECTIVE: Elimination of the fixed lesser toe deformity by arthrodesis of the proximal or distal interphalangeal joints (PIP and DIP, respectively). INDICATIONS: Painful fixed deformity. PIP joint: fixed hammer toe or clawtoe. DIP joint: fixed mallet toe. Relative indication: flexible hammer toe, clawtoe or mallet toe. CONTRAINDICATIONS: General operative contraindications. Relative contraindications also include severe deformities affecting the metatarsophalangeal (MTP) joint, for which the arthrodesis should combine an operative procedure of the MTP joint...
June 2014: Operative Orthopädie und Traumatologie
R H Brumfield, J P Conaty
This article presents recommendations for reconstructive thumb surgery based on results obtained by team evaluation of 79 patients who had 186 thumb operations performed by the Arthritis Service at Rancho Los Amigos Hospital from January 1, 1962 through December 31, 1976. The operations included: 11 synovectomies and reconstructions, with synovitis recurring in two; 10 metacarpophalangeal silastic arthroplasties, with no infections or breakage; 11 carpometacarpal silastic arthroplasties, with dislocation in two and superficial infection in one; and 154 arthrodeses, with 139 fusions...
June 1, 1980: Orthopedics
K J Renfree
We compared the results of percutaneous in situ arthrodesis with open arthrodesis of the distal interphalangeal joint with a headless compression screw. In the percutaneous in situ arthrodesis group (17 joints), the screw was inserted from the fingertip across the unprepared joint. In the open group (12 joints), flat cancellous surfaces were prepared before screw insertion. Solid fusion was found in 10/17 joints (59%) with percutaneous in situ arthrodesis and in 11/12 joints (92%) with open arthrodesis. Among the other seven joints with percutaneous in situ arthrodesis, six had fibrous union and were asymptomatic at a mean of 18 months, and one failed, requiring revision...
May 2015: Journal of Hand Surgery, European Volume
Roya Mirmiran, Brandon Wilde, Michael Nielsen
Arthrodesis is a common procedure indicated for surgical treatment of end-stage degenerative joint disease of the foot and ankle. Many published studies have reviewed the union rate, focusing on specific technique or fixation. However, studies reporting on the average period required to achieve fusion, irrespective of the type of fixation or surgical method used, have been lacking. We report on the union rate and interval to fusion in patients who had undergone primary arthrodesis of various joints of the foot and ankle...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Christopher Cox, Brandon E Earp, W Emerson Floyd, Philip E Blazar
PURPOSE: To study the results of using a small, headless compression screw (AcuTwist) for thumb interphalangeal (IP) joint and finger distal interphalangeal (DIP) joint arthrodeses. METHODS: Between November 2007 and January 2012, 48 primary arthrodeses of the thumb IP joint or DIP joint in the other digits were performed in 29 consecutive patients with AcuTwist devices. Indications for arthrodesis included 19 cases of osteoarthritis in 25 fingers, 3 cases of lupus in 9 fingers, 2 cases of post-traumatic osteoarthritis in 2 fingers, and 1 case and finger each of acute trauma, neuromuscular disorder, postinfectious osteoarthritis, boutonniere deformity, and Dupuytren contracture...
January 2014: Journal of Hand Surgery
Takuji Iwamoto, Noboru Matsumura, Kazuki Sato, Shigeki Momohara, Yoshiaki Toyama, Toshiyasu Nakamura
PURPOSE: To assess the outcomes of our technique involving oblique headless compression screw for arthrodesis of the thumb interphalangeal joint and the distal interphalangeal joints of the other digits. METHODS: A total of 28 joints (19 thumb interphalangeal and 9 distal interphalangeal) in 23 patients with a mean age of 65 years (range, 58-74 y) were retrospectively analyzed. All operations were performed with the Acutrak2 micro-screw. After the resection of synovium and joint cartilage by a dorsal approach, a 0...
December 2013: Journal of Hand Surgery
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