[Arthrodesis of the interphalangeal joint of the thumb: indication, technic, results]

A series of 32 arthrodeses of the interphalangeal joint of the thumb has been reviewed and the results are presented. Using a figure-of-eight wire and two crossed K-wires, the tension band principle is observed. Thus, with a minimum of material, durable stability is achieved that permits reliable healing and early use of the thumb under increasing load. The morbidity is reduced to a reasonable duration of five weeks. The angle of arthrodesis should be adapted to the professional requirements: Instrument grip (large or disc grip) is best with a small angulation of 5 to 10 degrees, while for precision grip a larger angle of 20 to 30 degrees is preferred. Tactile gnosis is best preserved when pronation of 5 to 10 degrees and slight ulnar deviation of 5 degrees of the distal phalanx in relation to the proximal phalanx is achieved. For ten years, the H-shaped incision has been used with good results in our department. However, some patients have shown anesthetic skin areas distal to the incision. We therefore have changed to a fork-shaped incision, which better preserves the cutaneous innervation.