DIP Joint Fusion Info Consent
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Why this operation has been suggested
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. DIP joint fusion joins the smallest finger bone to the one above it. We call this joint replacement with a solid bone bridge. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. For long-standing wear-and-tear arthritis, we usually try non-operative care first. This includes activity changes, hand therapy, splinting, and injections. Surgery follows when that has not given enough improvement.
Your surgeon may recommend this if you have severe pain or instability in the tip of your finger. The goal is to stop the pain and give you a stable finger. You will trade some bending motion for strength. This allows you to grip objects without pain. We consider this when other treatments have failed to help. The operation aims to provide lasting relief and better function in your daily tasks.
Before the operation
You must fast for seven hours before your surgery. Your surgeon will tell you exactly which medicines to stop. Please arrange a lift home for the day of your procedure. Wear comfortable, loose clothing to your appointment. Bring a complete list of all current medications and supplements. You may need blood tests or an anaesthetic review to ensure you are fit for surgery. X-rays help us plan the best approach for your joint. These steps keep you safe and help your surgeon prepare for a smooth operation.
On the day
You will present to the hospital's surgical admissions unit. Here, you are checked in and prepared for theatre. You meet the anaesthetist to discuss your comfort options. This operation can be done under local anaesthetic (an injection that numbs just the area of surgery, with you awake) or under general anaesthetic (fully asleep). Most people choose local — recovery is quicker and you can go home soon after. If you'd prefer to be asleep, that's also a reasonable choice — discuss it with your surgeon and anaesthetist.
You are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable, you either go to the ward or go home, depending on the procedure and your recovery.
What the operation involves
Your surgeon makes a single cut over the back of your finger joint. This open approach gives clear access to the area that needs treatment. Through this incision, your surgeon carefully prepares the joint surfaces. The goal is to remove the worn cartilage so the bones can heal together into one solid piece.
To hold the bones steady while they fuse, your surgeon uses a low-profile plate and screws. These are placed on the back of the finger. The hardware is designed to sit flat against the bone, reducing the chance of irritation under the skin. Your surgeon positions the joint carefully to ensure it heals in a functional position for your hand.
Once the bones are securely fixed, your surgeon closes the cut. The skin is stitched back together, and a dressing is applied to protect the site. This procedure allows your finger to become stable and pain-free by eliminating movement at the arthritic joint.
After the operation
You will wake up in the recovery ward with your hand elevated and dressed. Most patients stay one night in hospital after this operation, though some are able to go home the same day. We provide pain relief to keep you comfortable. A protective splint or bandage will cover your finger. You must have someone stay with you for the first 24 hours to help with basic tasks. Do not drive while wearing the splint if it prevents a safe grip on the wheel. Please read our guide on Driving after upper-limb surgery for more details. Your surgeon will advise when you can remove the splint and resume normal activities.
Recovery
In the first few days, you will likely feel soreness and swelling around your finger. This is normal. Keep your hand elevated above your heart as much as possible to help reduce swelling. Your surgeon may prescribe pain relief to keep you comfortable. Most people find that discomfort eases significantly once the initial swelling settles.
You will wear a protective splint or cast to keep the joint stable while it heals. Do not remove this dressing unless your surgeon tells you to. You can use your other hand for most daily tasks, but avoid gripping or pinching with the operated finger. Sleep on your back or on the unaffected side, with your hand supported on pillows. This position helps prevent stiffness and reduces throbbing at night.
As your wound heals, you will begin gentle movement exercises. Your surgeon will guide you on when to start these activities. Hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. She will teach you specific movements to restore flexibility and strength without stressing the fusion site. You will gradually reintroduce light activities as movement returns and pain decreases.
You must not drive while wearing a finger splint if it prevents a safe grip on the wheel. See Driving after upper-limb surgery for more details. You can typically return to driving once the splint comes off and your surgeon clears you.
Recovery varies between individuals. Your timeline may differ; your surgeon and hand therapist will guide you based on your healing progress.
What can go wrong
Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.
If the bone does not heal properly, you may feel persistent pain or notice that the joint feels unstable. This is called a nonunion. It means the bones have not fused together as expected. You should contact your surgeon if pain does not improve over time or if the finger feels weak.
Sometimes, the metal hardware used to hold the bone in place can cause irritation. You might feel a lump under the skin or notice discomfort when wearing gloves or rings. In some cases, this leads to a need for a second procedure to remove the hardware. Let your surgeon know if the metal feels prominent or causes skin breakdown.
Infection is a serious risk with any surgery. You might notice increasing redness, warmth, or swelling around the incision. The area may become more painful than usual, or you might develop a fever. If you see pus or notice the wound opening up, seek medical attention immediately. Early treatment is key to resolving these issues.
If you have had previous joint replacements or surgeries in the same hand, the risk of complications may be higher. The tissue may be scarred, making healing more difficult. Your surgeon will discuss these specific risks with you before the procedure. Be sure to report any new symptoms promptly so they can be addressed quickly.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you have a fever, increasing redness or discharge from your wound, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Contact us immediately if you lose sensation or cannot move your limb. These signs need urgent assessment to keep your recovery on track.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the DIPJ arthritis page.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the DIPJ arthritis page.
