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Joint fusion

Joint fusions are generally performed for either osteoarthritis or rheumatoid arthritis. The main indication for joint fusions is pain or deformity. When you have a joint fused that joint will not move ever again. However if the operation is successful it should not be painful.

ANAESTHETIC

General or regional anaesthetic.

OPERATIVE PROCEDURE

The procedure can be done under local anaesthetic or general anaesthetic. The local anaesthetic is generally an anaesthetised arm rather than an anaesthetised digit. An incision is made over the joint, the joint surfaces are excised, the ends of the bone are then placed together and held by either wires or screws. Once the fixation is solid the wound is then closed. The finger will probably immobilised with a finger stool dressing, which will have some plaster incorporated in it so that it is not feasible to move the finger. The wound will be removed at two weeks and splint will be needed for a further four weeks.

RESULTS

Fusions are generally 90% successful. This means that the bone is joined in 90% of cases.

COMPLICATIONS

  1. Non-union. In 10% of cases the bones do not joint. If this is the case these non-unions can be painful or painless. If is painless I don't do anything, if it is painful I would re-do the operation.
  2. Infection. An uncommon complication in the hand. It is easily treatment with antibiotics.
  3. Algodystrophy / Complex regional pain syndrome. A rate complication (1%) but one that can give symptoms that are worse than the original symptoms. This involves the hand becoming stiff, painful, swollen and changing colour. Symptoms may not completely resolve.