Dorsal Plate Fixation for Distal Interphalangeal Joint Arthrodesis of the Fingers and Thumb

Patel, Anand; Damodar, Dhanur; Dodds, Seth D.

doi:10.1016/j.jhsa.2018.03.049

Cited by 3 publications

(7 citation statements)

References 11 publications

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“…Distal interphalangeal (DIP) joint arthrodesis is the most frequently performed procedure within this case series. Various treatment techniques including K-wire fixation, compression screw and plate fixation, bioabsorbable nail fixation or intramedullary elastic implant fixation are described [24][25][26][27][28]. Reported union rates vary in current literature and complication or revision rates are hard to compare [24,26].…”

Section: Discussionmentioning

confidence: 99%

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Pastl¹,

Schimetta

2021

Arch Orthop Trauma Surg

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Introduction The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device. Materials and methods A single-surgeon case series of 32 patients who had undergone hand or foot surgery with the application of an allogeneic bone screw with an average follow-up time of 1 year is reported. Clinical data were reviewed to evaluate the pain levels and satisfaction of the patients and the frequency and type of complications occurring during the healing process. Routine radiography and computed tomography were reviewed to determine the fusion rate, the ingrowth behavior of the transplant and the possible occurrence of transplant failure. Results High patient satisfaction was paired with low postoperative pain levels and a low complication rate. 97% of the patients were free of pain at the timepoint of the second follow-up examination, the mean time of recovery of full mobility was 50.1 ± 26.1 days after surgery. Wound healing disturbance occurred only in two cases. Bony consolidation of the osteotomy or arthrodesis gap as well as osseointegration of the transplant was seen in all cases. No transplant failure or transplant loosening occurred. Conclusions The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.

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Section: Discussionmentioning

confidence: 99%

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Pastl¹,

Schimetta

2021

Arch Orthop Trauma Surg

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“…Vorteil der dorsalen Plattenarthrodese ist, dass diese eine einfachere Versteifung in Flexionsstellung ermöglicht, woraus, gerade beim IP-Gelenk des Daumens, eine Funktionsverbesserung resultieren kann. Weiterhin zeigt sich bei dorsaler Platzierung der Platte eine hohe biomechanische Stabilität gegen Flexions-und Rotationskräfte [86]. Limitierend sind die anatomischen Verhältnisse, welche eine Platzierung und suffiziente Fixierung der Platte erschweren können.…”

Section: Plattenarthrodeseunclassified

“…Patel und Mitarb. führten sechs Arthrodesen des IP-Gelenkes von dorsal mittels 6-Loch-Doppelsteg-Platten (1,5 mm) durch und erzielten eine Konsolidierungsrate von 100 % ohne Komplikationen [86].…”

Section: Plattenarthrodeseunclassified

“…6 Röntgenbild in zwei Ebenen einer DIP-Gelenksarthrodese mit X-Fuse ® ▶Abb. 7 Röntgenbild in zwei Ebenen einer DIP-Gelenksarthrodese mit Fixateur externe Verzicht auf eine Ruhigstellung, Fingerschienen unterschiedlicher Länge bis hin zu einer vollständigen Ruhigstellung unter Einschluss des Handgelenkes für verschiedene Zeiträume [24,44,86]. Die meisten Autoren bevorzugen jedoch eine Ruhigstellung des DIP-Gelenkes bis zum Abschluss der Wundheilung bzw.…”

Section: Nachbehandlungunclassified

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Die Arthrodese des Fingerendgelenkes: eine Literaturanalyse

Vonderlind

Eisenschenk

Strüwer

et al. 2021

Handchir Mikrochir Plast Chir

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“…The principles of arthrodesis involve preparation of the DIPJ by debriding the articular cartilage and cortical bone until a healthy cancellous bone is exposed, followed by stable fixation with compression. Various methods of fixation have been described for the arthrodesis of the DIPJs, including Kirschner wire (K-wire) [4], Headless Compression Screw (HCS) [5,6], circumferential wiring and K-wire fixation [7,8], plate fixation [9,10], specialised implants [11,12], and even minimally invasive techniques [13] based on the size of the distal phalanx.…”

Section: Introductionmentioning

confidence: 99%

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

Lee¹,

Lee

Choi

et al. 2021

Handchir Mikrochir Plast Chir

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Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

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Dorsal Plate Fixation for Distal Interphalangeal Joint Arthrodesis of the Fingers and Thumb

Cited by 3 publications

References 11 publications

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Die Arthrodese des Fingerendgelenkes: eine Literaturanalyse

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

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