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Finger Joint Fusion

What is it?
A fusion is a technique of stiffening a damaged joint in order to improve pain in that joint. It is used for osteoarthritis, rheumatoid arthritis and in some cases of infection or trauma / injury.  All joints on the finger can be fused. This is however at the expense of impaired movement and hence function. The finger is “set” in a position that will allow the maximum use of the finger/hand. It will however “get in the way” for certain activities.

How is it done?
The surgery may be undertaken under a local anaesthetic or a general anaesthetic depending upon which joint is being fused.  The end joint of the finger ( distal inter-phalangeal joint) is usually fused with a screw under a local anaesthetic.

The proximal inter-phalangeal joint is usually fused with wires or a plate and is most commonly undertaken under a general  ( with you asleep) or regional anaesthetic ( arm asleep/numb) 

Wound care
You will be placed in a bulky dressing and either a splint or plaster  after the surgery. This will usually remain in place until the incision is starting to heal. At that point a custom made plastic splint will usually be made. It can take over 6 weeks for the bone to fuse ( join together). The joint will need to be protected during that time.

What are the complications?
The majority of patients are  very satisfied with the outcome of surgery. Whilst uncommon, all surgical procedures are associated with some  risks. Every effort is made to minimize these to ensure the best possible outcome from your surgery.

Infection-approximately 1%, will usually respond to antibiotics and occasionally require further surgery.

Wound/healing problems , this may lead to painful scars and require prolonged dressings and occasionally further surgery

Non-union – the bones may  be slow to join or rarely not join. This is more common if you smoke or have other medical problems with your health.

Metal work problems with tendon and soft tissue irritation

Tendon or nerve damage – surrounding structures may rarely be damaged

CRPS – complex regional pain syndrome, this is an uncommon but serious complication. It can on rare occasions leave you with a less function in the  hand with on-going pain stiffness and swelling. See section on CRPS.