Flat Feet Research - Flatfoot, Fallen Arches, Children, Treatment, Arthrodesis

Flat Feet Research Today is a free monthly online journal that collates and summarizes the latest research about Flat Feet, including details on flatfoot, fallen arches, children, treatment, arthrodesis.


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Use of a headless compressive screw for distal interphalangeal joint arthrodesis in digits: clinical outcome and review of complications.

Brutus JP, Palmer AK, Mosher JF, Harley BJ, Loftus JB

Division of Plastic Surgery, Hôpital Notre Dame du CHUM, Montreal, Quebec, Canada, and the Department of Orthopedic Surgery, Division of Hand Surgery, Upstate Medical University, Syracuse, NY, USA. jpbrutus@hotmail.com

PURPOSE: Arthrodesis of the distal interphalangeal joint (DIPJ) or thumb interphalangeal joints can be necessary to treat pain, deformity, or instability associated with arthritis. Compression and rigid fixation are thought to influence fusion rates and time to union favorably. The purpose of the study was to review the clinical outcome and complications associated with the use of a fully threaded headless compression screw for DIPJ arthrodesis. METHODS: Twenty-seven distal interphalangeal or thumb interphalangeal fusions were performed with an axial Mini-Acutrak screw in 22 patients. Charts, surgical reports, and preoperative and postoperative x-rays were reviewed to determine the incidence, time to union, and complications. The minimal follow-up period was 3 months. RESULTS: Twenty-three of the 27 arthrodeses achieved bony union. Complications included symptomatic nonunion (n=1, treated with secondary fusion), asymptomatic nonunion (n=2, left untreated), infection (n=4; 2 patients required implant removal that resulted in nonunion but declined revision) and nail bed injury (n=3). CONCLUSIONS: The Mini-Acutrak screw technique achieves healing rates that are comparable with but not superior to other techniques. Its main advantages are ease of execution, fully buried hardware, and early mobilization; however, the procedure is associated with complications and meticulous technique is required to avoid them. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Published 30 January 2006 in J Hand Surg [Am], 31(1): 85-9.
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Volume 1 (2005)
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