Tension band arthrodesis of small joints in the hand

Two-hundred three patients underwent 290 tension band arthrodeses of the metacarpophalangeal and proximal interphalangeal joints of the hand. Nine patients (3%) failed to achieve bony union, four had painless pseudarthroses, and one patient had a small finger amputation. Twenty-five fusions (9%) required hardware removal. There were 10 superficial infections (all responded to oral antibiotic therapy), and three fusions were malrotated. Tension band arthrodesis is our choice for fusion of the metacarpophalangeal and proximal interphalangeal joints. It is reliable and provides stable fixation, pins do not protrude, and external splinting is unnecessary in the cooperative patient.