synonyms:PIP Fusion, PIP arthrodesis, proximal interphalangeal joint fusion, proximal interphalangeal joint arthrodesis
PIP Fusion CPT
PIP Fusion Indications
- PIP joint pain, deformity and funtional loss secondary to arthritis(osteo/inflammatory/post-traumatic/post-infectious).
- Chronic tendon rupture
PIP Fusion Contraindications
- Active infection
- Occupation or hobby which requires PIP motion
PIP Fusion Alternatives
PIP Fusion Planning / Special Considerations
- Fixation options: K-wires, tension bands, intraosseous wiring, plates
- PIP joint IF, MF fused 15-30°.
- PIP joint RF, SF fused at 30-45° .
PIP Fusion Technique
- Pre-operative antibiotics, +/- regional block
- Digital block anesthesia +/- intravenous sedation.
- Supine position. All bony prominences well padded.
- Prep and drape in standard sterile fashion.
- Penrose drain may be used as a tourniquet.
- Dorsal H, transverse or Y-incision.
- Extensor mechanism is exposed and incised transversely exposeing the PIP joint.
- Verify reduction and screw placement with fluoroscopy.
- Close in layers.
PIP Fusion Complications
- Pin-tract infection.
- Deep infection/osteomyelitis.
- Painful hardware.
- Cold intolerance.
PIP Fusion Follow-up care
- Post-Op: bulky hand dressing with volar splint. Keep elevated.
- 10-14 Days: Wound check, splint applied. Active and passive MCP ROM encouraged.
- 6 Weeks: review xrays for signs of union.
- 3 Months: return to full activities if pain free and union evident by xray.
PIP Fusion Outcomes
PIP Fusion Review References