Interphalangeal joint fusion of thumb surgical technique
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Arthrodesis of the interphalangeal joint of the thumb is a widely performed procedure in hand surgery.
The most common indication is degenerative arthritis and occasionally post traumatic or inflammatory arthritides.
A variety of other indications exist. These include severe articular disruption from trauma, irreparable tendon injury, loss of function from neurological conditions and reconstruction following tumour resection.
A range of techniques have been described to fuse the interphalangeal joint of the thumb. These include dorsally placed low profile plates and intramedullary compression screws. Each technique has its unique advantages. Fusion rates overall are reported at 80-100%. Tension band wiring is a tried and tested, cost effective method that that remains in wide use today. The principle of tension band wiring is to convert a distracting force into a compressive one.
Most fusions of the thumb interphalangeal joint are set at between 0-30 degrees. It is important to come to an agreement with the patient after consideration of their occupation and desired function. In this example case, the patients unique functional needs demanded that his joint be fused in a degree of flexion that would be difficult to achieve with an intramedullary device.
Author: Tahseen Chaudhry FRCS (Tr and Orth), Consultant Hand and Peripheral Nerve Surgeon
Institution: The Queen Elizabeth Hospital, Birmingham, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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