Osteoarthritis commonly impacts the finger distal interphalangeal (DIP) joints. The prevalence of DIP joint arthritis is high, with more than 60% of individuals older than 60 having DIP joint arthritis.
Operative treatment for arthritis of the DIP joint is indicated for pain, deformity, dysfunction, and instability in patients who are recalcitrant to conservative measures. Arthrodesis, or the fusion, of the DIP joint is a widely accepted surgical treatment for DIP joint arthritis.
Several surgical techniques have been historically described, with headless compression screw (HCS) fixation being a particularly common technique because of its advantages, including reliable compression, rigid fixation, lack of prominence, and no need for removal. This video demonstrates arthrodesis using HCS for arthritis in the right ring finger DIP joint.
Christopher W. DiGiovanni, MD Chief of the Foot & Ankle Service Vice Chair for Academic Affairs Massachusetts General Hospital
Subtalar arthrodesis is currently the mainstay treatment option for the management of recalcitrant subtalar arthrosis.
The patient in this case is a 45-year-old male who developed post-traumatic arthritis of the subtalar joint 14 years following a work-related injury in which he sustained a comminuted, joint-depression type calcaneal fracture after a 10-foot fall from a ladder. Seven years after the initial injury, imaging prompted by progressive hindfoot pain during weight-bearing or following activity revealed progressive degeneration of the subtalar joint, for which he was treated with orthoses, corticosteroid injections, and arthroscopic debridement. After exhausting both conservative and minimally invasive treatment measures at 14 years post-injury, he finally elected to undergo subtalar arthrodesis.
This video article details the methods and techniques involved in subtalar arthrodesis. After an Ollier approach was used to expose the subtalar joint, the arthritic cartilage was removed and the subchondral plate was perforated. Finally, an autogenous bone graft was harvested from the proximal tibia and inserted into the joint space, and compression was achieved by two lag screws.
