Minimally Invasive Percutaneous Arthrodesis of a Finger Proximal Interphalangeal Prepared Joint, a Cadaveric Feasibility Study.

OBJECTIVE: Traditionally, the procedure for proximal interphalangeal (PIP) joint fusion has been described with an open approach using a dorsalcurvilinear incision. Due to the inherent risk of soft tissue complications with this technique, we propose a percutaneous technique for resecting bone cartilage and achieving a stable fusion angle with two mini-incisions, one lateral and one dorsal. The goal of all arthrodesis techniques is to create a stable joint fusion at the most functional angle for activities of daily living.

MATERIALS AND METHODS: A small, low speed high torque straight burr was introduced into the joint through a lateral joint line stab incision. The joint space was enlarged with manual traction, and chondral resection was performed under fluoroscopy. The PIP joint was then fused in adequate position with a headless compression screw through a dorsal stab incision. The joints were subsequently dissected to evaluate the degree of resection, the percentage of appropriately prepped joint surface, and any evidence of tissue damage. This study was conducted using 10 cadaver hands and included 39 joints.

RESULTS: This study demonstrated that joint preparation and fusion angle can be reproducibly achieved while preserving a non-disrupted soft tissue envelope. Taken together, these findings suggest that the described percutaneous PIP arthrodesis technique has strong potential for achieving favorable clinical outcomes.

CONCLUSION: Minimally invasive percutaneous PIP joint arthrodesis appears to be a feasible alternative technique that offers the advantage of minimal soft tissue disruption while achieving a stable construct for joint fusion.