Joint Fusions of the Fingers & Wrist
Joint fusion is a surgical procedure that involves removal of the damaged ends of the joint and fusing them together. Fusion prevents the movement of the joint and allows it to realign by itself.
Arthritis of the finger and wrist damages the articular cartilage which results in pain and inflammation.
It is a common surgical procedure done if the cartilage or bone in the finger is completely damaged due to arthritis. In the arthroscopic fusion surgery incisions are made at the dorsal surface (back) of the joint which are to be fused. The tendons are separated so that the two ends of the bone are brought closer for fusion. Surgeon removes the articular cartilage from both the joint surfaces and inserts metal pins and screws at the centre of both the bones. Metal pins and screws help to connect the two bones together and prevent the movement of these bones allowing them to fuse. Later, the soft tissues are stitched.
Cast or splint is placed over the finger joint until the bone completely fuses together.
There are two types of fusion. In the first type, a contoured plate is fixed at the back of the wrist joint using metal screws. The entire articular cartilage is removed from the wrist, allowing the bone to fuse with the metal plate. In the second type, a metal pin is passed into the wrist through the middle knuckle joint. The second type is usually performed on patients suffering from rheumatoid arthritis.
Cast or splints are not required in the first type of surgery. Patients are allowed to move their finger soon after the surgery. Swelling is observed which can be treated by elevation above the heart level for few weeks after surgery. In case of splints or pins, cast or splints are placed until the bone is completely healed.
Rehabilitation is generally suggested after the surgery which helps to control pain and swelling. Gentle massages and strengthening exercises will help to improve the grip strength and movement.