BACKGROUND:
Interphalangeal joint arthritis from degenerative or traumatic causes can lead to pain as well as a significant decrease in activities of daily living. Following conservative management distal joint fusion has been the mainstay of treatment. Open techniques range from Kirschner wiring fixation to dorsal mini-plate fixation and all other described methods have their associated indications, advocates and complications. We reviewed our series of patients who underwent arthrodesis using buried headless compression screws (either through an open technique or percutaneous approach) and evaluated timing of reported decrease in pain of the affected joint, rate of fusion and complications.
METHODS:
A retrospective chart review of twenty-two consecutive patients (three male, nineteen female) and twenty-seven joints that underwent open or percutaneous placement of a buried headless compression screw was carried out. Operative reports, preoperative and postoperative radiographs, and postoperative visit notes were reviewed to assess for bony fusion, alleviation of preoperative symptoms (i.e. pain) and complications.
RESULTS:
All of the twenty-two patients who underwent this procedure reported a decrease in pain of the affected joint on his/her first postoperative visit (approximately 14 days following surgery). All twenty-two patients also had radiographic signs that their affected joint had either fused. There was no hardware failure in any patient, no complication related to the arthrodesis portion of the surgery and no patient had to be re-operated upon.
CONCLUSIONS:
In our twenty-two patient review that included a total of twenty-seven joints we observed that subjective pain had decreased within two weeks (seen at the first postoperative visit) in all joints, the eventual fusion rate was 100% and no complications (i.e. infection, hardware failure) were seen.
We surmise that the use of a buried headless compression screw for interphalangeal joint arthrodesis is a superior treatment option for distal joint fusion.