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[Finger joint arthrodesis with the cup and cone technique : A simple and safe procedure]
Adrian Sebald1, Andreas Arkudas1, Raymund E Horch2
1Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg FAU, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
Background:
Finger joint arthrosis frequently results from trauma, degenerative or inflammatory causes. When conservative treatment and joint-preserving procedures fail, arthrodesis remains a reliable surgical option to relieve pain and restore hand function. Among the various techniques, the cup and cone method has proven particularly effective due to its large cartilage-free surface area and ease of intraoperative axis correction. The aim of this study is to evaluate this based on the patient cohort of a supramaximum care provider.
Material And Methods:
A retrospective analysis of 201 finger joint arthrodeses in 168 patients was conducted between 2015 and 2025. Data collected included demographics, joint location, surgical indications and postoperative complications. A subgroup analysis of arthrodesis performed for degenerative osteoarthritis included comparison of preoperative and postoperative axis deviation and flexion angles per joint type.
Results:
Patients had a mean age of 60 years and 71% were male. The right hand was affected in 54% of cases. Most arthrodeses involved proximal interphalangeal (PIP) joints (104), followed by distal interphalangeal (DIP, 65) and thumb IP joints (16). The leading indication was posttraumatic arthritis (48%), followed by degeneration (20%). Complication rates were low, with infection being the most common. In degenerative osteoarthritis cases, significant postoperative reductions in axis deviation were observed (up to 25°).
Conclusion:
Arthrodesis of the finger joints is an effective measure for improving function and relieving symptoms in treatment-refractory cases. The cup and cone technique has proven to be a procedure with a high success rate and a low complication rate. Individual planning of joint positioning and careful selection of the surgical technique are crucial for the functional outcome. Future prospective studies should further investigate long-term effects and patient satisfaction.
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