Abstract
Aim
Distal interphalangeal joint (DIPJ) arthrodesis is a well-accepted treatment of disease in the DIPJ of the hand. The ideal technique should be technically simple, quick, cheap, have minimal complications and yield a rapid return to function. Recent large published series report major complications of 11.1% and minor complications of 26% for this procedure. The study objective is to determine patient satisfaction and complication rates of DIPJ fusion using the Autofix screw (Small Bone Innovations, France), a smaller diameter headless compression screw.
Methods
A standard questionnaire was devised to assess patients' overall satisfaction and complications related to the procedure. This data is compared to equivalent procedures published internationally. The patient's radiological records were reviewed to determine bone union at 7 weeks post-operation.
Results
39 fingers were fused in 29 participants. Mean follow up was 36 months (range 2–48 months). Patient satisfaction was above 90%. We had a major complication rate of 2.56%, a minor complication rate of 20.5%. There was a higher rate of complications in patients younger than 60 years of age.
Discussion
Our technique for the insertion of the Autofix, headless compression screw is shown. It is a simple, quick and effective technique for the fusion of distal interphalangeal joints of all fingers; there is no ‘down-time’, and complication rates are superior to the largest series published in international literature. Furthermore, we demonstrated 100% union by 7 weeks in our patient sample. We attribute these results to 3 aspects of the procedure. 1) The Autofix screw is a smaller diameter screw than previously used for this procedure. 2) The screw generates significant compression across the fusion site. 3) We utilise bone graft as part of our routine management
NO DISCLOSURES
