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Reamed Percutaneous Arthrodesis for Distal Interphalangeal Joint Arthritis Improves Bone Fusion and Pain Compared
Juan Maria Pardo Garcia1, Pablo Sanchez-Urgelles2, Belen Pardos Mayo3
1The University of Texas Health Science Center at Houston, USA.
Background:
Distal interphalangeal joint (DIPJ) arthrodesis is the treatment of choice for DIPJ arthritis when conservative measures fail. However, open arthrodesis and non-reamed percutaneous techniques have been associated with high rates of nonunion and complications. This study aimed to evaluate and compare the outcomes of a minimally invasive technique for DIPJ arthrodesis that incorporates percutaneous articular surface reaming with those of a non-reamed percutaneous technique.
Methods:
A retrospective study was conducted on patients with DIPJ arthritis who underwent either reamed or non-reamed percutaneous DIPJ arthrodesis using headless cannulated compression screws, with a minimum follow-up of 2 years. The outcomes assessed included preoperative and postoperative visual analog scale scores, functional outcomes (Quick Disabilities of the Arm, Shoulder, and Hand), radiographic evidence of union, degree of residual axial malalignment, complication rate, subjective osteophyte elimination, and patient satisfaction at final follow-up.
Results:
A total of 12 patients underwent non-reamed percutaneous DIPJ arthrodesis, and 10 patients received the reamed technique. Bone union was achieved in 100% of patients in the reamed group compared with 50% in the non-reamed group, with faster healing observed in the reamed group (6 vs 8 weeks). The complication rate was lower in the reamed group (30%) than in the non-reamed group (58%). Postoperative pain scores were also lower in the reamed group (0 vs 1.5), and functional outcomes at final follow-up were similar between groups.
Conclusions:
Reamed percutaneous DIPJ arthrodesis is associated with higher union rates achieved in a shorter time and reduced postoperative pain compared with the non-reamed percutaneous technique.
Level Of Evidence:
III, Therapeutic.
