Abstract
Purpose To assess the outcomes of our technique involving oblique headless compression screw for arthrodesis of the thumb interphalangeal joint and the distal interphalangeal joints of the other digits. Methods A total of 28 joints (19 thumb interphalangeal and 9 distal interphalangeal) in 23 patients with a mean age of 65 years (range, 58-74 y) were retrospectively analyzed. All operations were performed with the Acutrak2 micro-screw. After the resection of synovium and joint cartilage by a dorsal approach, a 0.88-mm diameter guide wire was inserted at the ulnar side of the proximal phalanx in the thumb and radial side of the middle phalanx in the other digits from proximal to distal to fix the joint obliquely. We verified its position under fluoroscopic control and placed the cannulated screw from proximal to distal over the guide wire. Results Intraoperative rigid fixation was obtained except for 1 case, which required additional K-wire fixation. The overall union rate was 96%. Average time to fusion was 11 weeks (range, 8-30 wk), with 76% achieving union within 3 months. There were 2 complications, 1 nonunion and 1 late infection. Other complications such as dorsal skin necrosis, nail deformity, and paresthesia did not occur. Conclusions Efforts to avoid invasion of the nailbed can be technically demanding. We believe that our proximal to distal technique with oblique placement of the headless compression screw is a straightforward and effective method with a relatively low risk of complication. Type of study/level of evidence Therapeutic IV.
| Original language | English |
|---|---|
| Pages (from-to) | 2360-2364 |
| Number of pages | 5 |
| Journal | Journal of Hand Surgery |
| Volume | 38 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2013 Dec |
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Keywords
- Arthrodesis
- distal interphalangeal joint
- headless compression screw
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
An obliquely placed headless compression screw for distal interphalangeal joint arthrodesis. / Iwamoto, Takuji; Matsumura, Noboru; Satou, Kazuki; Momohara, Shigeki; Toyama, Yoshiaki; Nakamura, Toshiyasu.
In: Journal of Hand Surgery, Vol. 38, No. 12, 12.2013, p. 2360-2364.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An obliquely placed headless compression screw for distal interphalangeal joint arthrodesis
AU - Iwamoto, Takuji
AU - Matsumura, Noboru
AU - Satou, Kazuki
AU - Momohara, Shigeki
AU - Toyama, Yoshiaki
AU - Nakamura, Toshiyasu
PY - 2013/12
Y1 - 2013/12
N2 - Purpose To assess the outcomes of our technique involving oblique headless compression screw for arthrodesis of the thumb interphalangeal joint and the distal interphalangeal joints of the other digits. Methods A total of 28 joints (19 thumb interphalangeal and 9 distal interphalangeal) in 23 patients with a mean age of 65 years (range, 58-74 y) were retrospectively analyzed. All operations were performed with the Acutrak2 micro-screw. After the resection of synovium and joint cartilage by a dorsal approach, a 0.88-mm diameter guide wire was inserted at the ulnar side of the proximal phalanx in the thumb and radial side of the middle phalanx in the other digits from proximal to distal to fix the joint obliquely. We verified its position under fluoroscopic control and placed the cannulated screw from proximal to distal over the guide wire. Results Intraoperative rigid fixation was obtained except for 1 case, which required additional K-wire fixation. The overall union rate was 96%. Average time to fusion was 11 weeks (range, 8-30 wk), with 76% achieving union within 3 months. There were 2 complications, 1 nonunion and 1 late infection. Other complications such as dorsal skin necrosis, nail deformity, and paresthesia did not occur. Conclusions Efforts to avoid invasion of the nailbed can be technically demanding. We believe that our proximal to distal technique with oblique placement of the headless compression screw is a straightforward and effective method with a relatively low risk of complication. Type of study/level of evidence Therapeutic IV.
AB - Purpose To assess the outcomes of our technique involving oblique headless compression screw for arthrodesis of the thumb interphalangeal joint and the distal interphalangeal joints of the other digits. Methods A total of 28 joints (19 thumb interphalangeal and 9 distal interphalangeal) in 23 patients with a mean age of 65 years (range, 58-74 y) were retrospectively analyzed. All operations were performed with the Acutrak2 micro-screw. After the resection of synovium and joint cartilage by a dorsal approach, a 0.88-mm diameter guide wire was inserted at the ulnar side of the proximal phalanx in the thumb and radial side of the middle phalanx in the other digits from proximal to distal to fix the joint obliquely. We verified its position under fluoroscopic control and placed the cannulated screw from proximal to distal over the guide wire. Results Intraoperative rigid fixation was obtained except for 1 case, which required additional K-wire fixation. The overall union rate was 96%. Average time to fusion was 11 weeks (range, 8-30 wk), with 76% achieving union within 3 months. There were 2 complications, 1 nonunion and 1 late infection. Other complications such as dorsal skin necrosis, nail deformity, and paresthesia did not occur. Conclusions Efforts to avoid invasion of the nailbed can be technically demanding. We believe that our proximal to distal technique with oblique placement of the headless compression screw is a straightforward and effective method with a relatively low risk of complication. Type of study/level of evidence Therapeutic IV.
KW - Arthrodesis
KW - distal interphalangeal joint
KW - headless compression screw
UR - http://www.scopus.com/inward/record.url?scp=84888436069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84888436069&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2013.09.026
DO - 10.1016/j.jhsa.2013.09.026
M3 - Article
C2 - 24183505
AN - SCOPUS:84888436069
VL - 38
SP - 2360
EP - 2364
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
SN - 0363-5023
IS - 12
ER -