PIP Arthrodesis 26860

 

 

 

 

 

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
  • Burns

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.
  • Irrigate.
  • Close in layers.

PIP Fusion Complications

  • Pin-tract infection.
  • Deep infection/osteomyelitis.
  • Painful hardware.
  • Nonunion.
  • 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