Artritis ng DIPJ Impormasyon

Ano ang nararamdaman mo

Maaaring mapansin mo ang pagkakasikip at sakit sa pinakahuling kasu-kasuan ng iyong daliri. Ito ang distal interphalangeal joint, o DIPJ. Ang hindi komportableng pakiramdam ay madalas na tila malalim na pananakit. Maaari nitong gawing mahirap ang mga simpleng galaw. Maaaring mahirapan kang baluktotin nang buo ang dulo ng iyong daliri. Tinatawag itong flexion contracture. Sa paglipas ng panahon, maaaring magbago ang hugis ng kasu-kasuan. Maaari itong umusbong ng isang kurba na kilala bilang swan neck deformity.

Ang sakit ay madalas na lumala matapos mong gamitin ang iyong kamay. Ang mga gawain na nangangailangan ng pagpipitak o pagkupot ay nagiging pagod. Maaaring mahirapan kang umabot sa likod mo upang isara ang bra. Ang pagtatakip ng damit sa loob ng pantalon ay maaaring maging awkward o masakit. May mga tao na nararamdaman ang pagkakasikap kapag gising pa lamang sila. Karaniwang humihina ito habang gumagalaw ang iyong kamay. Gayunpaman, maaaring bumalik ang sakit matapos ang matagal na aktibidad.

Sa ilang kaso, maaaring lumipat ang kasu-kasuan mula sa tamang posisyon. Tinatawag itong subluxation. Ito ay nangyayari kapag nasira ang ibabaw ng kasu-kasuan. Maaaring makita o maramdaman mo ang pagbabago sa pagkakahanay ng daliri. Ang balat sa itaas ng kasu-kasuan ay maaaring maging sensitive. Maaaring mapansin mo ang pamamaga na pumapasok at lumalabas. Ang sakit sa gabi ay mas bihira ngunit maaari itong mangyari kung may pamamaga sa kasu-kasuan.

I-eeksamin ng iyong surgeon ang iyong kamay upang maunawaan ang mga sintomas na ito. Susuriin nila kung gaano karami ang galaw ng kasu-kasuan. Maaari silang maghanap ng mga senyales ng wear-and-tear arthritis. Tinatawag din itong osteoarthritis. Ito ay kasama ang mga pagbabago sa cartilage at buto. Ipapaliwanag ng iyong surgeon ang kahulugan ng mga natuklasan para sa iyo. Ususurin nila ang mga opsyon upang matulungan ang pagbawas ng iyong sakit at pagpapabuti ng function.

Ano ang nangyayari talaga

Ang joint sa dulo ng iyong daliri ay isang maliit na bisagra na nagbibigay-daan sa iyo na humawak at kumapit. Sa loob nito, ang dalawang dulo ng buto ay nakakubli ng makinis na kartilago. Ang kartilagong ito ay nagsisilbing shock absorber, na nagpapahintulot sa mga buto na dumulas sa isa’t isa nang walang alitan. Sa paglipas ng panahon, maaaring magkasira ang patong na ito dahil sa edad, sugat, o paulit-ulit na stress. Kapag ito ay naging manipis, ang mga buto ay magsisimulang magkuskosan nang direkta sa isa’t isa. Ito ay nagdudulot ng sakit, stiffness, at pamamaga. Maaaring mapansin mo na pakiramdam ng joint ay magaspang o nakakabit kapag sinusubukan mong galawin ito.

Ang joint ay pinagkakaisa ng matibay na manggas na tinatawag na capsule at sinusuportahan ng mga ligament. Kung ang ibabaw ng joint ay seryosong nasira, ang mga buto ay maaaring lumipat mula sa kanilang tamang posisyon. Ito ay tinatawag na subluxation. Kapaganagan ito, ang joint ay nawawalan ng normal na hugis at katatagan. Maaaring makita mo ang kitang-kita na buntot o deformity sa dulo ng iyong daliri. Ang maling pagkakahanay ay naglalagay ng karagdagang stress sa mga nakapaligid na tissue, na nagpapatigil sa mga pang-araw-araw na gawain tulad ng pagbutones ng damit o pag-type.

Ang mga tendon ay may mahalagang papel din sa paggalaw ng iyong daliri. Ang mga ito ay parang matibay na lubid na humihila sa iyong daliri upang baluktotin ito. Kung ang tendon ay nasugatan o ang joint ay unstable, ang balanse ng mga puwersa ay nagbabago. Ito ay maaaring magdulot ng abnormal na mga pattern ng pagbaluktot, tulad ng swan-neck deformity, kung saan ang joint ay sobrang baluktot. Ang pag-unawa sa mga mekanikal na pagbabagong ito ay tumutulong sa pagpapaliwanag kung bakit sapat na ang simpleng pahinga. Ang structural na pagkasira ay nangangailangan ng target na paggamot upang muling maibalik ang function at mawala ang sakit.

Mga maitutulong namin

Ang aming pamamaraan sa klinika ay sumasalamin sa paraan ni Dr. Kieran Hirpara, isang iskoltiko sa itaas na bahagi ng katawan sa Mater Private Hospital Rockhampton, sa pamamahala ng kondisyong ito. Sinisimulan namin ang konserbatibong paggamot upang pamahalaan ang sakit at mapanatili ang pag-andar. Ang pag-splint ng distal interphalangeal joint ay nagbabawas ng sakit at nagpapabuti ng extension nang hindi nagdudulot ng stiffness o paghihigpit sa iyong range of motion. Inirerekomenda rin namin ang pagbabago sa aktibidad at hand therapy upang panatilihing gumagalaw ang joint. Pakitandaan na ang immobilization ng joint na ito ay nagbabawas ng kabuuang lakas ng hawak, at ang epekto ay mas malinaw mula sa index hanggang sa little fingers. Karaniwang sinusubukan namin ang non-operative na paggamot para sa mga degenerative na problema at isinasalang-ala ang operasyon lamang kung hindi ito nagbibigay ng sapat na pagpapabuti.

Kung hindi sapat ang mga simpleng hakbang, tatalakayin namin ang mga opsyon sa medikal na pamamahala. Maaari kang kumain ng gamot pang-alis ng sakit o anti-inflammatories upang kontrolin ang hindi komportableng pakiramdam. Makakatulong din ang mga injection. Ang mga cortisone injection ay nagbabawas ng pamamaga upang magbigay ng pansamantalang ginhawa. Ang mga hyaluronic acid injection ay naglalayong maglubricate ng joint, habang ang mga platelet-rich plasma (PRP) injection ay gumagamit ng sarili mong blood components upang suportahan ang paggaling. Nag-iiba ang tagal ng ginhawa depende sa indibidwal at uri ng injection. Para sa mga pasyenteng may joint contractures, maaaring maging opsyon ang collagenase injections, bagaman maingat naming tinatimbang ang panganib ng pagbabalik ng kondisyon. Ang aming assessment sa klinika, kabilang ang history, examination, at imaging kung kinakailangan, ay tumutulong sa amin na matukoy kung aling opsyon ang angkop sa iyong partikular na sitwasyon.

Isinasalang-ala ang operasyon kapag naabot na ng konserbatibong paggamot ang hangganan nito at ang sakit ay malaki ang epekto sa iyong pang-araw-araw na buhay. Nag-aalok kami ng ilang mga paraan sa operasyon depende sa kondisyon ng iyong joint. Para sa matinding sakit sa parehong middle at end joints ng iisang daliri, maaari naming gamutin ang pareho nang sabay-sabay. Kung nais mong mapanatili ang galaw, maaaring mag-cheilectomy kami upang alisin ang mga bone spur o gumamit ng denervation upang bawasan ang mga signal ng sakit. Para sa mga gustong may stable at walang sakit na joint, ang fusion (arthrodesis) ay isang karaniwang pagpipilian. Nag-aalok din kami ng silicone interpositional arthroplasty bilang isang alternatibong nagpapanatili ng galaw, na nagtitiyak ng mahusay na pag-alis ng sakit at range of movement na 30–40 degrees na may mababang kabuuang rate ng komplikasyon na 5%. Ipinapresente namin ang mga opsyong ito bilang isang shared decision, na tinitiyak na nauunawaan mo ang mga benepisyo at trade-off ng bawat landas.

Ano ang inaasahan

Ang iyong prognosis ay nakadepende sa kung paano kumilos ang iyong arthritis at sa anong landas ng paggamot ang iyong pipiliin. Kung walang paggamot, kadalasang sumusunod ang kondisyon sa isang likas na dehenratibong proseso. Kung nakaranas ka ng fracture ng mallet finger, maaaring umusbong ang wear-and-tear arthritis sa kasukasuan. Maaaring mapansin mo ang pagbaba ng kakayahang yumuko ng iyong daliri. Gayunpaman, karaniwang hindi malaki ang epekto ng pagkawala ng galaw na ito sa iyong pang-araw-araw na gawain o sa kasiyahan sa kamay.

Kung mabigat at masakit ang arthritis, karaniwang nananatili ito at maaaring lumala sa paglipas ng panahon. Sa ilang kaso, maaaring umusbong ang deformidad na "swan neck" sa kasukasuan, kung saan yumuyuko ang daliri sa hindi karaniwang paraan. Ang pag-unlad na ito ay pinapagana ng lumalaking stiffness at contracture sa kasukasuan. Kung parehong sobrang sakit ang gitnang at dulo na kasukasuan ng parehong daliri, maaaring irekomenda ng iyong surgeon na gamutin ang pareho nang sabay-sabay upang maibalik ang balanse at gawain.

Sa paggamot, inaasahan mo ang malaking pagbaba ng sakit. Kung pipili ka ng fusion procedure, ang layunin ay alisin ang sakit sa pamamagitan ng pagkakaisa ng mga buto. Madalas itong napakaepektibo. Kung mas gusto mong panatilihin ang ilang galaw, available ang mga alternatibo tulad ng silicone joint replacement o denervation kasama ang bone shaving. Halimbawa, karaniwang nagbibigay ang silicone replacement ng mahusay na pagbaba ng sakit at nag-aallow ng saklaw ng galaw na 30–40 degrees. Mababa ang kabuuang rate ng komplikasyon para sa partikular na prosedurang ito, sa 5%.

Iba-iba ang pakiramdam ng recovery depende sa prosedura. Ang pag-splint ng kasukasuan ay maaaring bawasan ang sakit at mapabuti ang extension nang hindi nagdudulot ng stiffness o hindi pagsunod. Para sa mga nagsasagawa ng fusion, karaniwang maganda ang mga resulta, na may maaasahang bone union at mataas na kasiyahan ng pasyente. Kahit na mabigo ang isang dating silicone implant, maaaring tugunan ng customized bone grafting ang pagkawala ng buto at makamit ang maaasahang union. Tutulungan ka ng iyong surgeon na bigyang-kahulugan ang mga opsyon na ito base sa iyong mga partikular na pangangailangan, tinitiyak na naiintindihan mo ang realistikong mga benepisyo at limitasyon ng bawat landas.

Kailan kumonsulta sa doktor

Humingi ng pagsusuri ng espesyalista kung mayroon kang patuloy na sakit sa kasukasukan ng dulo ng daliri na hindi gumagaling kahit magpahinga. Maghanap ng medikal na tulong kung mapapansin mo ang kahinaan, kawalan ng katatagan, o pakiramdam ng pagkakasara o pagbagsak ng daliri. Maaaring magpahiwatig ang mga sintomas na ito ng paglala ng depekto, tulad ng swan neck deformity, o malubhang pinsala sa kasukasukan. Ang biglaang paglala ng mga sintomas ay dahilan din upang humingi ng tulong. Ang maagang pagsusuri ay tumutulong sa iyong doktor na maunawaan ang pag-unlad ng arthritis na dulot ng pagkasira o mga pagbabago na dulot ng trauma. Ito ay nagbibigay-daan sa tamang pamamahala upang mapanatili ang kakayahan at kaginhawaan ng kamay. Huwag balewalain ang mga senyales na nagiging mahirap ang iyong mga araw-araw na gawain dahil sa mga isyu sa kasukasukan.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Percutaneous DIP joint arthrodesis is advantageous compared with open fusion techniques in select patients [1].
Swan neck deformity progresses significantly over time due to increasing DIPJ flexion contracture [2].
Simultaneous surgical intervention is recommended for severe painful osteoarthritis of both the PIP and DIP joints of the same digit [3].
Denervation with cheilectomy presents a motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis [4].
Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods but with fewer major complications [5].
The combination of DIP arthrodesis and PIP Swanson arthroplasty results in favorable outcomes regarding simultaneous bony union and flexibility [7].
Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees [8].
Silicone interpositional arthroplasty of the DIP joint has a low overall complication rate of 5% [8].
The smile incision and reverse shotgun approach is a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary [9].
The nonaxial multiple small screws (NMSS) technique is a feasible option for DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required [11].
Customized structural bone grafting addresses bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction [13].
There is no difference in biomechanical performance between K-wires and compression screws for DIPJ arthrodesis [20].
Implant selection for DIPJ fusion should consider factors such as cost and complication profiles given the lack of difference in biomechanical performance between K-wires and compression screws [20].

Anatomy & Pathophysiology

Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [6].
Understanding of DIP joint morphology may lend insight into the biomechanics and disease progression within the DIP joints [10].
A substantial number of distal phalanges are too small to accommodate commonly available headless compression screws, particularly in females and the small finger [31].
Irreducibility was more commonly seen in dorsal than in volar dislocations of the DIP joint [33].
Volar dislocations of the DIP joint carried a higher risk of instability immediately after reduction compared to dorsal dislocations [33].
Biomechanically, dynamic tenodesis for the DIP joint using the remaining FDP tendon results in a flexion angle greater than 30 degrees [23].
In a cadaveric model, tenodesis successfully restored coordinated interphalangeal joint flexion after a simulated zone I FDP laceration with improvements in DIP joint flexion and composite finger flexion [35].
Lateral blocking with incremental joint angles allows a safer application of force for the healing tendon during palmar and lateral blocking exercises [26].

Classification

Swan neck deformity in the DIP joint progresses significantly over time due to increasing DIPJ flexion contracture [2].
Radiological osteoarthritis following a mallet finger fracture follows a similar course to the natural degenerative process in the DIP joint [12].
Post-traumatic osteoarthritis of the DIP joint after mallet finger fractures is accompanied by a decrease in range of motion, though this does not clinically affect patient-reported outcome measures (PROMs) [12].
The interrater reliability of the Kellgren & Lawrence classification system for post-traumatic osteoarthritis in the DIP joint after mallet finger fractures is considerably lower than initially assumed [34].
The interrater reliability of the OARSI classification system for post-traumatic osteoarthritis in the DIP joint after mallet finger fractures is considerably lower than initially assumed [34].
Current concepts regarding DIP joint osteoarthritis highlight the roles of cartilage, subchondral bone, and soft tissue structures in etiology, pathogenesis, and evaluation [19].
Morphological understanding of DIP joint curvatures may provide insight into the biomechanics and disease progression within the DIP joints [10].
Examination of type I and type II nerve endings provides new information on the sensory systems of the DIP joints and surrounding structures [32].

Clinical Presentation

Swan neck deformity in the DIPJ progresses significantly over time due to increasing DIPJ flexion contracture [2].
Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity [17].
Radiological osteoarthritis following a mallet finger fracture is similar to the natural degenerative process in the DIP joint [12].
Radiological osteoarthritis after a mallet finger fracture is accompanied by a decrease in range of motion of the DIP joint [12].
Radiological osteoarthritis after a mallet finger fracture does not clinically affect patient-reported outcome measures (PROMs) [12].
Primary synovial chondromatosis of the DIPJ is an extremely rare entity that requires accurate diagnosis to distinguish from other arthropathies [27].
Understanding the morphology of DIPJ curvatures may lend insight into the biomechanics and disease progression within the DIP joints [10].
Osteoarthritis of the DIPJ involves roles of cartilage, subchondral bone, and soft tissue structures in its etiology, pathogenesis, and evaluation [19].

Investigations

Lateral approach and plate fixation for DIP joint arthrodesis yields results equivalent to traditional methods with fewer major complications [5].
Silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees with a low overall complication rate of 5% [8].
Understanding the morphology of DIP joints may lend insight into the biomechanics and disease progression within the DIP joints [10].
Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint [12].
Immobilization of the distal interphalangeal joint of any finger reduces the overall grip strength of the hand [16].
The reduction in grip strength from DIP joint immobilization becomes progressively more pronounced from the index to the little fingers [16].
Open reduction and internal fixation is a viable treatment option for chronic floating DIP joint injuries, though osteoarthritis may develop [17].
Arthrodesis of the distal interphalangeal joint often leads to complications [18].
Current concepts regarding DIP joint osteoarthritis examine the etiology, pathogenesis, and evaluation of the condition, highlighting the roles of cartilage, subchondral bone, and soft tissue structures [19].
A size mismatch existed between the anatomic dimensions of the DIP joint and commercially available headless compression screws [21].
A distinct collagen septum exists between the extensor tendon and skin at the DIP joint [38].

Treatment

Simultaneous anterograde screw arthrodesis of the DIP joint and silastic PIP joint replacement results in favorable outcomes regarding bony union and flexibility [7].
Diabetes and surgeon experience are factors increasing the risk of postoperative complications in DIP/thumb IP joint arthrodeses [14].
Splinting of the DIP joint reduces pain and improves extension at the joint without causing non-compliance, increased stiffness, or restriction of range of motion [15].
Injection with collagenase Clostridium histolyticum is an option for the treatment of DIP joint contractures in Dupuytren disease, though the potential risk for recurrence should be carefully weighed [36].
Open DIP joint cheilectomy is a safe and effective alternative to DIP joint arthrodesis in patients with symptomatic osteoarthritis who wish to preserve joint motion [37].

Complications

Palmar subluxation of a DIP joint is expected when more than one half of the dorsal articular surface is injured, even without preexisting arthritic deformity [6].
Radiological osteoarthritis following a mallet finger fracture follows a natural degenerative process and is accompanied by a decrease in DIPJ range of motion [12].
Diabetes is identified as a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
Surgeon experience is identified as a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
Failed Swanson's arthroplasty of the DIPJ can result in bone stock loss and medullary absence [13].

Recovery

Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the DIP joint [12].
The decrease in range of motion of the DIP joint following radiological osteoarthritis from a mallet finger fracture does not clinically affect PROMs [12].
Diabetes is a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
Surgeon experience is a factor increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [14].
Splinting of the DIP joint reduces pain and improves extension at the joint [15].
Splinting of the DIP joint does not give rise to non-compliance, increased stiffness, or restriction of range of motion [15].

Key Evidence

[L4] In select patients, this percutaneous DIP joint arthrodesis is advantageous in comparison with open fusion techniques. [1] (10.1007/s11552-010-9265-9)
[L5] The swan neck deformity in this individual progressed significantly with time because of increasing DIPJ flexion contracture. [2] (10.1016/j.jht.2009.11.005)
[L3] The authors recommend simultaneous surgical intervention in case of severe painful OA of the PIP and DIP joints of the same digit. [3] (10.1177/17531934231191255)
[L4] It presents a compelling motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis. [4] (10.1016/j.jhsa.2026.01.027)
[L4] The results obtained in this small series are equivalent to the traditional methods of DIP joint arthrodesis but with fewer major complications. [5] (10.1016/j.jhsa.2007.09.004)
[L5] Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured. [6] (10.1016/j.jhsa.2007.09.006)
[L4] The combination of DIP arthrodesis and PIP Swanson arthroplasty resulted in a favourable outcome in terms of simultaneous bony union and flexibility. [7] (10.1177/17531934231215790)
[L4] The study confirms that silicone interpositional arthroplasty of the DIP joint is an acceptable alternative to arthrodesis, achieving excellent pain relief and a range of movement of 30–40 degrees with a low overall complication rate of 5%. [8] (10.1177/1753193411422679)
[L4] This technique may be a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary. [9] (10.1186/s12891-024-08016-6)
[L5] Our understanding of morphology may lend insight into the biomechanics and disease progression within the DIP joints. [10] (10.1007/s11552-014-9605-2)
[L4] Thus, the NMSS technique could be used as a feasible option in DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required. [11] (10.1186/s12891-022-05473-9)
[L4] Radiological OA after an MFF is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint, which does not clinically affect PROMs. [12] (10.1016/j.jhsa.2023.03.027)
[L4] A customized structural bone graft using the described technique addresses issues of bone stock loss and medullary absence in failed DIPJ silicone arthroplasty, achieving reliable union rates and high patient satisfaction. [13] (10.1177/17531934231151217)
[L3] Diabetes and surgeon experience were identified as factors increasing the risk of postoperative complications in these DIP/thumb IP joint arthrodeses. [14] (10.1186/s12891-024-07361-w)
[L2] It does not give rise to non-compliance, increased stiffness or restriction of range of motion. [15] (10.1016/j.jht.2013.08.004)
[L4] Immobilization of the distal interphalangeal joint of any finger reduces the overall grip strength of the hand, with the effect becoming progressively more pronounced from the index to the little fingers. [16] (10.1177/1753193418765068)
[Case_report] Floating DIP joint injuries can be misdiagnosed initially due to minimal deformity; open reduction and internal fixation is a viable treatment option for chronic cases, though osteoarthritis may develop. [17] (10.1016/j.jhsa.2010.05.025)
[L3] Arthrodesis of the distal interphalangeal joint often leads to complications. [18] (10.1177/17531934221111641)
[L5] This current concepts article examines the recent knowledge base regarding the etiology, pathogenesis, and evaluation of osteoarthritis of the distal interphalangeal joint, highlighting the roles of cartilage, subchondral bone, and soft tissue structures. [19] (10.1016/j.jhsa.2010.09.003)
[L5] Given the lack of difference in biomechanical performance between K-wires and compression screws, consideration should be given to other factors such as cost and complication profiles when choosing an implant for DIPJ fusion. [20] (10.1177/1558944715627211)
[L4] A size mismatch existed between the anatomic dimensions of the DIP joint and commercially available headless compression screws. [21] (10.1016/j.jhsa.2014.02.007)
[L5] Biomechanically, dynamic tenodesis for the DIP joint using the remaining FDP tendon is a valuable procedure because it results in a flexion angle greater than 30 degrees. [23] (10.1016/j.jhsg.2020.08.007)
[L5] This study supports the concept that lateral blocking with incremental joint angles allows a safer application of force for the healing tendon. [26] (10.1016/j.jht.2020.07.004)
[Case_report] Primary synovial chondromatosis of the distal interphalangeal joint is an extremely rare entity that requires accurate diagnosis to distinguish from other arthropathies. [27] (10.1177/15589447211049520)
[L4] A substantial number of distal phalanges are too small to accommodate commonly available headless compression screws, particularly in females and the small finger. [31] (10.1007/s11552-014-9679-x)
[L5] Our examination of the distribution of type I and type II nerve endings provides new information on the sensory systems of the DIP joints and surrounding structures. [32] (10.1016/j.jhsa.2010.11.050)
[L4] Irreducibility was more commonly seen in dorsal than in volar dislocations, while volar dislocations carried a higher risk of instability immediately after reduction. [33] (10.1177/1753193415616957)
[L4] The interrater reliability of the Kellgren & Lawrence and OARSI classification systems for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed. [34] (10.1016/j.jhsa.2024.03.012)
[L5] In this cadaveric model, this tenodesis successfully restored coordinated interphalangeal joint flexion after a simulated zone I FDP laceration with improvements in distal interphalangeal joint flexion and composite finger flexion. [35] (10.1016/j.jhsa.2013.10.009)
[L4] Injection with CCH is an option for the treatment of DIP joint contractures in Dupuytren disease, though the potential risk for recurrence should be carefully weighed prior to its use. [36] (10.1016/j.jhsa.2018.07.004)
[L4] Open DIP joint cheilectomy is a safe and effective alternative to DIP joint arthrodesis in patients with symptomatic osteoarthritis who wish to preserve joint motion. [37] (10.1016/j.jhsa.2017.07.006)
[L5] We confirmed the existence of a distinct collagen septum between the extensor tendon and skin at the DIP joint using MRI and histology. [38] (10.1016/j.jhsa.2008.11.030)

References

[1] Treatment of Symptomatic Distal Interphalangeal Joint Arthritis with Percutaneous Arthrodesis: A Novel Technique in Select Patients. HAND. 2010. DOI: 10.1007/s11552-010-9265-9

[2] Swan Neck Deformity after Distal Interphalangeal Joint Flexion Contractures: A Biomechanical Analysis. Journal of Hand Therapy. 2010. DOI: 10.1016/j.jht.2009.11.005

[3] Does distal interphalangeal joint arthrodesis affect proximal interphalangeal joint arthroplasty outcomes in the same finger?. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231191255

[4] Denervation with Cheilectomy of the Distal Interphalangeal Joint: Technique and Medium-Term Results. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.01.027

[5] Alternative to the Distal Interphalangeal Joint Arthrodesis: Lateral Approach and Plate Fixation. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.09.004

[6] A Biomechanical Study of Distal Interphalangeal Joint Subluxation After Mallet Fracture Injury. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.09.006

[7] Simultaneous anterograde screw arthrodesis of distal interphalangeal joint and silastic proximal interphalangeal joint replacement for osteoarthritis. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231215790

[8] Joint replacement in 131 painful osteoarthritic and post-traumatic distal interphalangeal joints. Journal of Hand Surgery (European Volume). 2011. DOI: 10.1177/1753193411422679

[9] Smile incision and reverse shotgun approach in distal interphalangeal joint arthrodesis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-08016-6

[10] Curvatures of the DIP Joints of the Hand. HAND. 2014. DOI: 10.1007/s11552-014-9605-2

[11] Distal interphalangeal joint arthrodesis with nonaxial multiple small screws: a biomechanical analysis with axial headless compression screw and clinical result of 15 consecutive cases. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-05473-9

[12] Posttraumatic Osteoarthritis of the Distal Interphalangeal Joint: A Follow-Up Study of 12 Years After Nonsurgical Treatment of Mallet Finger Fractures. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.03.027

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