Die Arthrodese des Fingermittelgelenks mittels Zuggurtungsosteosynthese

OBJECTIVE: Arthrodesis of the proximal interphalangeal joint of fingers in a functional and pain-free position.

INDICATIONS: Primary and secondary osteoarthritis, traumatic joint destruction, posttraumatic malposition, instability, joint destruction due to infection, irreparable extensor and/or flexor tendon lesion, recurrent flexion deformity in Dupuytren's disease, arthritis (e. g., rheumatoid arthritis, psoriatic arthritis), failed resection arthroplasty, failed prosthesis, congenital disorder (e. g., camptodactyly).

CONTRAINDICATIONS: Persistent joint infection.

SURGICAL TECHNIQUE: Resection of the proximal phalanx head and the middle phalanx base, arthrodesis with figure-of-eight tension band wire in a functional position.

POSTOPERATIVE MANAGEMENT: Plaster of Paris cast with arthrodesis position of the affected finger and intrinsic plus position of at least one adjacent finger for 2 weeks, custom-made finger splint for 4 weeks.

RESULTS: A total of 15 of 16 patients with an arthrodesis of the proximal interphalangeal finger joint of the dominant hand by tension band wire were followed up after an average of 31 months. None was affected by the arthrodesis in everyday live. All patients were very satisfied with the result. Nine of 15 patients were free of pain both at rest and with activity. The average DASH score was 48 points. Grip strength averaged 29 kg, 7 % stronger than the contralateral hand.