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Distal interphalangeal joint arthrodesis with a headless compression screw: morphometric and functional analyses.

Joo-Hyoun Song¹, Joo-Yup Lee, Yang-Guk Chung

¹Department of Orthopedic Surgery, St. Vincent' Hospital, The Catholic University of Korea, 93 Ji-dong, Paldal-gu, Suwon 442-723, Korea.

Archives of Orthopaedic and Trauma Surgery

|October 21, 2011

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This study determined optimal headless compression screw sizes for distal interphalangeal (DIP) joint arthrodesis in Korean individuals, finding the Acutrak fusion screw effective for DIP fusion with good patient outcomes.

Area of Science:

Orthopedic Surgery
Hand Surgery
Radiology

Background:

Determining appropriate screw size is crucial for successful distal interphalangeal (DIP) joint arthrodesis.
Previous studies have not specifically addressed screw size selection for Korean populations.

Purpose of the Study:

To establish radiologic guidelines for selecting headless compression screws for DIP joint arthrodesis in Korean subjects.
To evaluate the clinical outcomes of using Acutrak fusion screws for DIP and thumb interphalangeal (IP) joint arthrodesis.

Main Methods:

Radiographic measurements of distal and middle phalanges in 500 Korean fingers were performed.
Screw size was determined based on narrowest cortical bone diameter (distal phalanx) and medullary canal diameter (middle phalanx).

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Clinical outcomes were assessed in 23 patients undergoing arthrodesis with Acutrak fusion screws, including time to union, pain scores, and functional assessments.

Main Results:

Specific mean diameters for distal and middle phalanges were established for various fingers and thumbs.
Mean time to union was 10 weeks, with a mean fusion angle of 11.9°.
Patients reported low pain (VAS 0.4) and good functional outcomes (Korean DASH score 5), with one case of intraoperative fixation failure.

Conclusions:

The Acutrak fusion screw is a viable option for DIP joint arthrodesis in Korean patients.
Careful technique is necessary, especially for the little finger, to prevent complications.
Alternative fixation methods should be considered for thumbs with wide medullary canals.