Risk factors in distal interphalangeal joint arthrodesis in the hand: a retrospective study of 173 cases

摘要

In this retrospective study we aimed to analyse the risk factors for complications after different methods of distal interphalangeal arthrodesis in the hand. Forty-four per?cent were treated with K-wire/cerclage fixation, 46% with X-fuse? implants (Stryker GmbH, Selzach, Switzerland) and 10% with headless compression screws (HBS?-screw, KLS Martin Group, Tuttlingen, Germany). The median follow-up was 16?weeks (range 6–224). The overall complication incidence was 44% (minor complications 29% and major 15%). The logistic regression showed that osteoarthritis, revisional arthrodesis and smoking had a negative impact on the total complication incidence. A Cox-regression analysis showed that HBS?-screw arthrodesis was associated with a significantly lower incidence of major complications compared with K-wire/cerclage and X-Fuse?-arthrodesis. Revisional arthrodesis was five times more frequently connected with major complications than primary surgery. Smokers were three times more likely to experience major complications than non-smokers. We conclude that arthrodesis of the distal interphalangeal joint often leads to complications. Risk factors must be kept in mind. Level of evidence: III.