PIP 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. We usually start with non-operative care like activity changes, hand therapy, splinting, or injections. Surgery is considered when these options have not given enough improvement.
Your surgeon may suggest this operation if you have severe pain or instability from wear-and-tear arthritis, previous injury, or inflammatory conditions. The goal is to stop the painful motion and provide a stable finger. This helps you perform daily tasks more easily. While some patients return to work after a median of 8 weeks, others may experience residual stiffness or minor pain for up to 3 months. We discuss these outcomes openly so you can make an informed choice about your care.
Before the operation
You must fast for seven hours before your surgery. Stop taking blood-thinning medicines as your surgeon advises. Arrange a lift home for the day of the procedure. Wear loose, comfortable clothing to your appointment. Bring a complete list of all current medications and supplements. You may need X-rays, blood tests, or an anaesthetic review beforehand. These checks ensure your body is ready for surgery and help your surgeon plan the safest approach. Please follow all specific instructions given to you by our team regarding preparation steps.
On the day
You present to the hospital’s surgical admissions unit. You are checked in and prepared for theatre. You meet the anaesthetist, who reviews your health and plans your comfort. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.
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 joint to access the area. This open approach allows clear visibility of the structures inside. The surgeon prepares the joint surfaces by removing the worn-out cartilage. This creates a clean surface for healing.
If you are having a joint replacement, your surgeon inserts new surfaces made of metal and plastic. These parts replace the damaged bone ends. If you are having a fusion, the bones are held together firmly. Your surgeon uses screws or wires to keep the bones steady while they heal into one solid piece. This stability helps the bone grow across the gap.
In some cases, your surgeon may also repair nearby tendons. For example, a tendon from your finger might be used to support the joint and prevent it from bending backward too far. This adds extra stability to the repair.
Once the joint is prepared and fixed, your surgeon closes the cut with stitches. A dressing is applied to protect the area. The operation typically takes a few hours, depending on the complexity of your specific case. You will not feel any pain during this time due to anaesthesia, which is managed separately by the anaesthetist.
After the operation
You will wake up in our recovery ward. We manage your pain with standard medication. Your hand will be dressed and placed in a splint to protect the joint. Most patients stay one night in hospital after this operation, though some are able to go home the same day. You must have someone stay with you for the first 24 hours. Do not drive while wearing the splint, as it prevents a safe grip on the wheel. You can drive once the splint comes off and your surgeon clears you. See Driving after upper-limb surgery for more details.
Recovery
You will have a splint on your finger for several weeks. This protects the joint while it heals. You must not drive while wearing the splint if it stops you from gripping the wheel safely. We will guide you on when it is safe to drive again, once the splint is removed and your surgeon clears you. For more details, see our guide on driving after upper-limb surgery.
In the first few days, some swelling and discomfort are normal. Keep your hand elevated above your heart to help reduce swelling. We will show you gentle exercises to keep your other fingers moving. Your hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. She will help you regain strength and movement safely.
As the swelling settles, you will gradually start using your hand for light tasks. You may notice some stiffness. This is part of the healing process. We will adjust your exercises as your movement returns. You will know you are ready for more activity once you can grip without pain. Your timeline may differ; your surgeon and hand therapist will guide you.
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 you have a joint replacement, the most common reason for needing another surgery is trouble with the tendons that straighten your finger. You might notice your finger feels weak or struggles to straighten fully. This happens because the extensor mechanism, which controls that movement, is not working as it should. If you feel this loss of function, let your surgeon know so they can assess the tendon.
Sometimes the joint replacement does not last as long as expected. This is more likely if you are younger or if the arthritis started after an injury. You might notice increased pain or instability in the finger over time. If the implant wears out or fails, you may need revision surgery. Be aware that repeat surgeries carry a higher risk of complications and may not restore full function.
If you need a fusion surgery to fix a failed replacement, the goal is to join the bones together so they heal into one solid piece. While this often works well, it is not always completely reliable. You might experience persistent pain or stiffness in the finger. In some cases, the bones do not fuse properly, which is called nonunion. If you have ongoing pain or notice the finger is still moving when it should be still, contact your clinic for a review.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you have fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Seek urgent care for loss of sensation or inability to move your hand. These signs need immediate assessment. We want to ensure your recovery stays on track and address any concerns quickly.
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 PIP Joint 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 PIP Joint Arthritis page.
