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DOS Kongressen 2017 ·
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Arthrodesis of the Proximal Interphalangeal Joint
Rasmus Wejnold Jørgensen, Jens-Christian Vedel, Claus Hjorth Jen-
sen
Hand Clinic, Department of Orthopedics, Herlev-Gentofte University Hospital
of Copenhagen
Background:
Arthrodesis of the proximal interphalangeal joint is indicated in
patients with painful and incongruent joints. Many techniques have been pro-
posed, but literature on the results is sparse.
Purpose / Aim of Study:
The purpose of this study was to assess healing and
complication rate after arthrodesis of the proximal interphalangeal joint using
plate fixation (PLF) or Kirschner- wire fixation (KWF).
Materials and Methods:
We retrospectively analyzed 33 charts with a mini-
mum follow-up of 2 years. 15 patients were operated on with the Leibinger
plate, 5 patients were operated with the Variax plate and 13 patients were op-
erated on with KW fixation. Patients were evaluated radiographically and clini-
cally at 6-8 weeks postoperatively. Fisher’s exact test was used for binary data
and Mann-Whitney test for numerical data. P<0.05 was considered statistically
significant.
Findings / Results:
In 19 of 20 cases, healing was obtained within 8 weeks
postoperatively in the PLF group. One patient was not seen until 12 weeks
postoperatively, healing was obtained at this point. 8 of 13 cases healed within
8 weeks in the KWF group. 5 cases required more than 8 weeks to obtain healing
(range 12-36 weeks) showing a lower fusion rate at this stage as compared to
PLF (P=0.023). In the KWF group 4 cases had the K-wires removed in an out-
patient setting and 4 patients in the OR, one Leibinger plate had to be removed
in the OR. One patient had an amputation in the PIP joint after KWF because of
continous pain for over 6 months. Mean number of outpatient visits to the clinic
following PLF was 4.5 and for KWF 5.53 (P=0.19).
Conclusions:
Proximal interphalangeal joint arthrodesis can be achieved with
either plate fixation or K-wire fixation. Union was eventually obtained in all pa-
tients. Fusion time is significantly shorter using plate fixation when comparing
to K-wire fixation.
No conflicts of interest reported
87.