Distal interphalangeal joint arthrodesis using the ADS memory staple – the London experience

Abstract

Background

The ADS memory staple is the first intramedullary shape device in use for distal interphalangeal joint arthrodesis.

Methods

A retrospective analysis of 17 consecutive patients undergoing single digit DIPJ arthrodesis using the memory staple between October 2013 and February 2018 by 2 consultant plastic surgeons at 2 London teaching hospitals was performed. Functional and patient-reported outcomes as well as complications were measured.

Results

Thirteen female (76%) and 4 male (24%) patients with a median age of 59 years (29–82 years) met our inclusion criteria, which included osteoarthritis (n = 4), traumatic arthritis (n = 8), rheumatoid arthritis (n = 4) and psoriatic arthritis (1). Thirteen DIPJs and 4 thumb IPJs were fused. Average follow-up time was 32.6 months (7.2–60 months). Four patients were retired, 2 unemployed and 11 actively working. Sixteen 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. Two patients developed a wound infection requiring antibiotics, 1 developed a hypertrophic scar, and 1 healed with a mildly rotated DIPJ. There were no instances of skin necrosis, cold intolerance, paraesthesia or osteomyelitis. All patients were satisfied with their final outcome despite the one displacement.

Conclusions

Within our small case series, we demonstrated a high union rate 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.

Level of evidence: Level 4, therapeutic study