Finger joint fusion (arthrodesis) is an operation to permanently stiffen a painful or unstable finger joint — either the proximal interphalangeal (PIP) or distal interphalangeal (DIP) joint. It provides a pain-free, stable finger in a functional position.
An incision is made over the affected joint. The cartilage is removed from both sides of the joint. The bones are aligned in a functional position (typically 20-40 degrees of flexion for PIP joints, 0-10 degrees for DIP joints) and fixed with a screw, wire, or plate. The operation takes 30-45 minutes per joint.
Fusion is recommended for painful arthritis (osteoarthritis or inflammatory), joint instability, mallet finger deformity not responding to splinting, and failed joint replacement.
Splinting, corticosteroid injection, and activity modification. Joint replacement is an alternative for PIP joints in selected patients.
X-rays. Day-case procedure.
Reliable pain relief and a stable finger. DIP fusion has minimal functional impact. PIP fusion eliminates pain but reduces overall finger function more significantly.
Expected — the fused joint is permanently stiff in a fixed position.
Wire or screw may be palpable.
Failure to fuse. Risk approximately 5-10%.
The joint may fuse in a suboptimal position.
Wound or bone infection.
Some patients report increased sensitivity to cold.
Local digital block, regional, or general anaesthesia.
Splint or K-wire protection for four to six weeks. Exercises for adjacent joints begin immediately. K-wire removal at four to six weeks if used. Full recovery two to three months.
X-ray at six weeks to confirm fusion.
DIP fusion has minimal functional impact — most people barely notice it. PIP fusion has a greater impact but provides a stable, pain-free finger that is more functional than a painful, stiff arthritic joint.