Arthrodesis of the Distal Interphalangeal Joint Using a Bioabsorbable Rod as an Intramedullary Nail

Abstract

There are several fixation techniques for arthrodesis of the distal interphalangeal joint. Since February 1999 we have used a bioabsorbable (poly-L-lactide, PLLA) rod as an intramedullary nail for arthrodesis of 15 distal interphalangeal joints and one interphalangeal joint of the thumb. The advantages include the absence of protruding hardware that would require removal, and technical simplicity. Preoperative diagnoses included degenerative arthritis in five patients, post-traumatic arthritis in 10 patients, and non-union after arthrodesis with crossed Kirschner wires in one patient. All patients were observed until there was clinical and radiographic evidence of fusion with the mean interval to fusion of 8 weeks (range 6-12). There were two cases of minor intermittent local swelling, which resolved. Fixation with a PLLA rod for arthrodesis of the distal interphalangeal joint is a simple and effective technique.

Distal interphalangeal joint arthrodesis with a headless compression screw: morphometric and functional analyses

“…Arata et al [8] stated that arthrodesis is a generally accepted operative treatment for arthritis of the DIP joint to relieve pain, and to correct deformity and instability when conservative measures have not improved the problem. Arthroplasty of the DIP joint is a much less commonly reported procedure.…”

Interphalangeal arthrodesis using an intramedullary nitinol implant: a prospective study

“…A systematic review of 32 studies (1,125 digits) analyzed the three most commonly reported techniques (K-wire, headless compression screw, cerclage wire), finding insufficient evidence to support any particular technique. [2] Rates of union reported for generalized screw arthrodesis are ranging from 80% to 100% within three months postoperatively, [3] showing similar results to other commonly performed techniques such as bioabsorbable rod as intramedullary nail, [4] intramedullary K-wire fixation and interosseous wiring, [8] as well as plate and screw fixation. [5] We were able to demonstrate a 95% primary fusion rate within the same time interval using the nitinol (X-Fuse ® ) system, therefore showing effective comparable results.…”

“…[3] Other possibilities are the use of a bioabsorbable implant (poly-L-lactide rod) as an intramedullary nail, [4] or to perform a plate fixation. [5] Although entire fixation of the respective joint mostly releases painful symptoms, functional procedures such as the pinching grip are difficult to perform.…”

Helical Conformation Endows Poly-<span style="font-variant: small-caps;">l</span>-Lactic Acid Fibers with a Piezoelectric Charge under Tensile Stress

“…Poly-l-lactic acid (PLLA) is well known as a bioabsorbable material and has been clinically used as bioabsorbable mini-plate, screw and pin [2,13,14,30,33]. On the other hand, PLLA is known as a piezoelectric material.…”

“…Various types of artificial ligaments including bioabsorbable material have been studied to reconstruct the injured ligament [3,27,31]. It has been suggested that early osteointegration of the grafted artificial ligament to the bone is important to improve the ligament function and durability [39].Poly-l-lactic acid (PLLA) is well known as a bioabsorbable material and has been clinically used as bioabsorbable mini-plate, screw and pin [2,13,14,30,33]. On the other hand, PLLA is known as a piezoelectric material.…”