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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Distal interphalangeal joint arthrodesis using the ADS memory staple – The London Experience

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  • presenting/speaker Arvind Mohan - St Thomas Hospital, London, United Kingdom
  • Anna Allan - Royal Free Hospital, London, United Kingdom
  • Andreas Fox - St Thomas Hospital, London, United Kingdom
  • Barbara Jemec - Royal Free Hospital, London, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-597

doi: 10.3205/19ifssh0865, urn:nbn:de:0183-19ifssh08654

Published: February 6, 2020

© 2020 Mohan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Aims: The ADS memory staple is the first intramedullary shape device in use for distal interphalangeal joint arthrodesis. We describe our experience of the device used in two hand units

Methods: An analysis of 17 consecutive patients undergoing single digit DIPJ arthrodesis using the device between October 2013 and February 2018 by two Consultant Plastic Surgeons at two London Teaching Hospitals was performed. Functional and patient reported outcomes as well as complications were measured.

Results and Conclusions: 13 female (76%) and 4 male (24%) patients with a median age of 59 years (29-82yrs) were operated on. Indications included osteoarthritis (n=4), traumatic arthritis (n=8), rheumatoid arthritis (n=4) and psoriatic arthritis (1). 13 DIPJs and 4 thumb IPJs were fused. Average follow up time was 32.6 months (7.2-60 months). 4 patients were retired, 2 unemployed and 11 actively working.

16 patients (94%) achieved bony union within 6 weeks of surgery and had a painless, functional hand. Device displacement occurred in 1 patient requiring removal and arthrodesis with K-wires. 2 patients developed a wound infection requiring antibiotics, 1 developed a hypertrophic scar and 1 healed with a mildly rotated DIPJ. There we no instances of skin necrosis, cold intolerance, paraesthesia or osteomyelitis. All patients were satisfied with their final outcome despite the one displacement.

Our study demonstrates high union rates without many of the complications associated with other arthrodesis techniques. We present a rapid, reliable and cost-effective method of DIPJ arthrodesis using a novel new technique with high rates of patient satisfaction.