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远端指间关节（DIPJ）关节炎 资料

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会注意到手指最末端的关节出现僵硬和疼痛。这是远端指间关节（DIPJ）。不适感通常表现为深部的酸痛。这会使简单的动作变得困难。您可能会发现难以完全弯曲指尖。这称为屈曲挛缩。随着时间的推移，关节可能会发生形态改变。它可能发展为一种称为天鹅颈畸形的弯曲。

疼痛常在使用手部后加剧。需要捏握的任务会使人感到疲劳。您可能难以将手伸到背后扣上胸罩。塞衬衫下摆可能会感到别扭或疼痛。有些人刚醒来时会感到僵硬。这通常在活动手部后缓解。然而，长时间活动后疼痛可能会再次出现。

在某些情况下，关节可能会错位。这称为半脱位。当关节面受损时会发生这种情况。您可能会看到或感觉到手指排列的改变。关节上方的皮肤可能会变得触痛。您可能会注意到时轻时重的肿胀。夜间疼痛较少见，但如果关节发炎则可能发生。

您的外科医生将检查您的手部以了解这些症状。他们将检查关节的活动范围。他们可能会寻找磨损性关节炎的迹象。这也称为骨关节炎。它涉及软骨和骨骼的变化。您的外科医生将解释这些发现对您的意义。他们将讨论有助于减轻疼痛和改善功能的选项。

实际发生了什么

您的指尖关节是一个小型铰链，使您能够进行捏握和抓握。内部，两块骨端覆盖着光滑的软骨。这种软骨像减震器一样，使骨头之间能够无摩擦地滑动。随着时间的推移，由于年龄、损伤或重复性压力，这层覆盖物可能会磨损。当软骨变薄时，骨头开始直接相互摩擦。这会导致疼痛、僵硬和肿胀。您可能会注意到关节在尝试活动时感觉有颗粒感或卡住。

关节由一个坚韧的囊状结构（关节囊）固定在一起，并由韧带支撑。如果关节表面受到严重损伤，骨头可能会移位。这称为半脱位。当这种情况发生时，关节失去其正常形状和稳定性。您可能会在指尖看到可见的肿块或畸形。这种错位会对周围组织施加额外压力，使扣衬衫纽扣或打字等日常任务变得困难。

肌腱在手指运动中起着关键作用。这些肌腱就像强韧的绳索，将手指拉向弯曲状态。如果肌腱受伤或关节不稳定，力的平衡就会改变。这可能导致异常的弯曲模式，例如天鹅颈畸形，其中关节过度弯曲。了解这些机械变化有助于解释为什么简单的休息往往不够。结构性磨损需要针对性的治疗来恢复功能并缓解疼痛。

我们能采取的措施

我们诊所采用的方法反映了 Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生对该疾病的管理方式。我们从保守治疗开始，以控制疼痛并维持功能。固定远端指间关节可减少疼痛并改善伸展，且不会导致僵硬或限制您的活动范围。我们还建议改变活动方式并进行手部治疗，以保持关节活动。请注意，固定该关节会降低整体握力，且从食指到小指的影响逐渐加剧。对于退行性问题，我们通常先尝试非手术治疗，仅当保守治疗未能提供足够改善时才考虑手术。

如果简单措施效果不足，我们将讨论药物治疗方案。您可以服用止痛药或抗炎药来控制不适。注射治疗也能提供帮助。皮质类固醇注射可减少炎症，提供暂时缓解。透明质酸注射旨在润滑关节，而富血小板血浆（PRP）注射则利用您自身的血液成分来支持愈合。缓解持续时间因人而异，且取决于注射类型。对于存在关节挛缩的患者，胶原酶注射可能是一个选项，尽管我们会仔细权衡复发的风险。我们诊所的评估，包括病史、体格检查以及必要的影像学检查，有助于我们确定哪种方案最适合您的具体情况。

当保守治疗已达极限且疼痛严重影响您的日常生活时，我们会考虑手术。根据您关节的状况，我们提供多种手术路径。如果同一手指的中节和末节关节均出现严重疼痛，我们可能会同时治疗这两个关节。如果您希望保留活动功能，我们可能会进行骨赘切除术以去除骨刺，或使用去神经术以减少疼痛信号。对于偏好稳定且无痛关节的患者，融合术（关节融合术）是常见的选择。我们还提供硅胶间置成形术作为保留活动功能的替代方案，该方案可实现良好的疼痛缓解，活动范围为 30–40 度，且总体并发症率仅为 5%。我们将这些选项作为共同决策提出，确保您充分了解每种路径的益处与权衡。

预期情况

您的预后取决于关节炎的病情演变以及您选择的治疗方案。若不进行治疗，该疾病通常会遵循自然退行性过程。如果您曾发生过锤状指骨折，关节处可能会出现磨损性关节炎。您可能会注意到手指弯曲活动度下降。然而，这种活动度丧失通常不会显著影响您的日常功能或对患手的满意度。

若关节炎严重且伴有疼痛，病情往往持续存在并可能随时间推移而加重。在某些情况下，关节可能出现“天鹅颈”畸形，即手指以异常方式弯曲。这种进展是由关节内日益增加的僵硬和挛缩所驱动的。如果同一手指的中节和远节关节均严重疼痛，您的外科医生可能会建议同时处理这两个关节，以恢复平衡和功能。

经过治疗后，您有望获得显著的疼痛缓解。如果您选择融合术，其目标是通过将骨骼连接在一起以消除疼痛。这通常非常有效。如果您希望保留一定的活动度，可选择硅胶关节置换或去神经联合截骨术等替代方案。例如，硅胶置换通常能提供卓越的疼痛缓解效果，并允许30–40度的活动范围。该特定手术的总体并发症率较低，为5%。

恢复过程因手术方式而异。对关节进行夹板固定可减少疼痛并改善伸展，且不会导致僵硬或不配合。对于接受融合术的患者，结果通常较为理想，骨愈合可靠且患者满意度高。即使之前的硅胶植入物失败，定制化的植骨术也可解决骨缺损问题并实现可靠的骨愈合。您的外科医生将根据您的具体需求帮助您权衡这些选项，确保您充分了解每种治疗路径的实际益处和局限性。

何时就诊

如果您的指尖关节持续疼痛且休息后无改善，请寻求专科医生评估。如果您注意到无力、不稳或出现卡住或打软腿的感觉，请及时就医。这些症状可能提示畸形加重，如天鹅颈畸形，或关节严重损伤。症状突然加重也是就医的理由。早期评估有助于您的外科医生了解磨损性关节炎或创伤相关病变的进展。这能够实现及时管理，以维持手部功能和舒适度。不要因为关节问题导致日常活动困难而忽视这些迹象。

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

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

[13] Salvage of failed Swanson’s arthroplasty of the distal interphalangeal joint. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231151217

[14] Arthrodesis of distal interphalangeal and thumb interphalangeal joint: a retrospective cohort study of 149 cases. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07361-w

[15] Splinting of the Distal Interphalangeal Joint Reduces Pain and Improves Extension at the Joint; Results Front the Splint-OA Study. Journal of Hand Therapy. 2014. DOI: 10.1016/j.jht.2013.08.004

[16] Effect of immobilization of the distal interphalangeal joint of fingers on grip strength. Journal of Hand Surgery (European Volume). 2018. DOI: 10.1177/1753193418765068

[17] Floating Distal Interphalangeal Joint Injury: Case Report. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.05.025

[18] Risk factors in distal interphalangeal joint arthrodesis in the hand: a retrospective study of 173 cases. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221111641

[19] Osteoarthritis of the Distal Interphalangeal Joint. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.09.003

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[21] Distal Interphalangeal Joint Bony Dimensions Related to Headless Compression Screw Sizes. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.02.007

[23] The Effect of Flexor Digitorum Profundus Dynamic Tenodesis on the Distal Interphalangeal Joint: A Cadaver Study. Journal of Hand Surgery Global Online. 2020. DOI: 10.1016/j.jhsg.2020.08.007

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[32] Distribution of Nerve Endings in Human Distal Interphalangeal Joint and Surrounding Structures. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.11.050

[33] Differences between dorsal and volar dislocations of the distal interphalangeal joint of fingers: a report of 30 cases. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193415616957

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[36] Collagenase Clostridium histolyticum for the Treatment of Distal Interphalangeal Joint Contractures in Dupuytren Disease. The Journal of Hand Surgery. 2019. DOI: 10.1016/j.jhsa.2018.07.004

[37] Cheilectomy for Treatment of Symptomatic Distal Interphalangeal Joint Osteoarthritis: A Review of 78 Patients. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.07.006

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