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Finger fusion

A joint fusion is an operation that involves removing the damaged ends of the joint and compressing them together until the bone has grown across the joint.

Finger fusions are often performed for osteoarthritis.  The most common joint to be fused is the distal interphalangeal joint (DIP joint).  This is the end finger joint, just behind the nail

Who does it affect?

Finger arthritis usually occurs in people over 40 years of age.

Why does it happen?

The articular cartilage, which is the slippery lining of the surface, has been worn away, and the exposed bones rub against each other, causing pain.  Therefore a small joint fusion,  is very successful at reducing this pain.  There are very few functional limitations as a consequence of fusing the DIP joint.

Symptoms

Normally seen as a painful, lumpy joint and a decreased range of movement.

Diagnosis

Finger arthritis usually has a stiff swollen joint, often with knobbly bumps.

Surgical treatment

Surgery is performed under local anaesthetic as a day case procedure and often under x-ray control.  An incision is made on the back of the joint.  The tendons are divided and the underlying bone prepared so that the two ends of the bone are freshened and come into close contact.  These are then held with a variety of fixation devices, most commonly stainless steel wires.  The wires are kept in place until the bone has united, usually somewhere between four and eight weeks.

There are a number of different methods of fixation of the DIP joint and these include exposed wires, buried wires under the skin, internal screw fixation. The results of each type of surgery are very similar, with a 90% chance of the bones healing.  The options will be discussed with your prior to treatment.

Post-surgery rehabilitation

If the wires are exposed these need protecting whilst in place.  If the wires are buried people can often return to activities relatively quickly.  Your individual circumstance will be discussed with you.

Return to normal routine

Once the bone has grown across the joint, a rapid return to function can be expected.

Risks

The main risk is the bones not growing together. This occurs in approximately 10% of cases, having lost symptoms from the performed surgery. Other minor (less than 1%) risks are infection and damage to the nail.

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