Proximal Interphalangeal Joint Arthrodesis via Kirschner Wire Fixation

Abstract

The end-to-end proximal interphalangeal joint arthrodesis has become the digital arthrodesis technique of choice. When performed properly, it produces a stable construct and affords for good long-term correction, high success rates, and satisfied patients. Traditionally, the preferred form of fixation of lesser digital arthrodesis was with a percutaneous Kirschner wire (k-wire). In recent years however, the number of fixation options for the correction of digital deformities has greatly expanded, mainly with internal implants. Advocates of these internal fixation devices claim that k-wire fixation has poor patient acceptance and has an increased risk for infection because of exposed wires. Although these internal fixation devices may have a higher patient acceptance rate, they have not been shown to have a higher fusion rate nor a higher patient satisfaction rate, and they are quite costly when compared to k-wires. The cost-effective solution is the buried k-wire. The k-wire can easily be transformed into an internal implant, so that there are increased patient acceptance and decreased risk of infection, and it still produces high fusion and success rates.