Abstract
Background Trauma resulting in severe comminution, bone loss, and articular involvement of the
fingers is a challenging injury. Osteosynthesis of the digits is nonviable when there
is an inability to restore a stable articular surface adequately. Acute arthrodesis
of the proximal and distal interphalangeal joints may be an option in such scenarios.
The aim of this study is to evaluate the role of finger joint arthrodesis in the setting
of trauma, in terms of fusion rates and clinical outcomes.
Materials and Methods Patients with injuries treated via acute finger arthrodesis between 2010 and 2012
at a single institution were retrospectively reviewed. Complete finger amputations
requiring replantation were excluded. Finger arthrodesis was performed acutely via
intraosseous cerclage wires, Kirschner wires, or tension band wiring. Fusion rates
were determined by plain radiography, and clinical outcomes were assessed with the
Disabilities of the Arm, Shoulder and Hand (DASH) score.
Results A total of 11 patients were recruited. All patients were males with an average age
of 35.3 years (range: 21–63 years). None of the cases involved the thumb, and there
was an equal distribution of injury amongst the fingers. Nine of the 11 patients involved
the distal interphalangeal joint with the remaining involving the proximal interphalangeal
joint. Radiologic union was achieved in 9 out of 11 patients, and the average time
to fusion was 75.5 days. The average DASH score for the patients was 16.5 (10.8–22.5).
All patients were able to return to their premorbid occupation, with average time
to return to work of 104.3 days (59–168 days). There were no cases of infection or
reoperation.
Conclusion We propose that posttraumatic acute arthrodesis of the finger joints is a viable
treatment in situations in which there is difficulty in restoring the articular congruity,
with early return to work and good function.
Keywords
acute arthrodesis - hand injury - interphalangeal joints
