Novel Minimally Invasive Approach for Arthrodesis in Distal Interphalangeal Joint Using Microscope.

Abstract

Arthrodesis is a definitive treatment for osteoarthritis of the distal interphalangeal (DIP) joint. The surgical approach is generally performed from the dorsal side of the DIP joint using a Y- or H-shaped incision. However, this approach can lead to relatively noticeable scarring and dorsal tissue complications. We introduced a microsurgery technique to address patients' desire for cosmetic improvement in addition to pain relief. In our modified approach, a small 1.5-cm skin incision was made along the mid-lateral line of the finger. This approach allows for a safer and faster synovectomy, osteophyte resection, and osteotomy in a limited surgical field. The joint was fixed by using a headless screw. In this article, we describe the application of this method for DIP arthrodesis. Our study included 12 women with a mean age of 63 years (51-83 y) and a mean follow-up period of 6 months (3-12 mo). All patients expressed satisfaction with the results. Bone union was successfully achieved in all fingers, leading to the resolution of pain without complications. The average postoperative score on the short version of the Disabilities of the Arm, Shoulder, and Hand questionnaire was 0. These findings suggest that the microsurgical approach is a minimally invasive and effective method for treating DIP arthrodesis.