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. 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.Aim
Methods
We reviewed 14 patients who underwent thumb lengthening over a four-year-period. Lengthening was performed for terminal deficiency in nine patients and for segmental bone loss in five. The callotasis method was used in eight patients and the Matev method in six. In all patients, the Orthofix mini-external fixator was used as the distracting device. Final gains in length ranged from 22 mm to 36 mm. The mean fixator application time was 89 days (68 to115). Complications included one malunion, one over-lengthening, two pin migrations through bone and four cases of pin-tract sepsis. There were no skin or neurovascular complications. These techniques are safe and provide useful alternatives to other methods of thumb reconstruction.
