Osteoarthritis of the finger joints nearest the fingertip

Wear and tear of the joint, also called arthrosis, is a wear and tear of the joint cartilage that occurs insidiously, usually unnoticed at first. Wear and tear of the finger end joints is noticeable in pain as well as deformation and misalignment of the joint. In most cases, the cause is unknown and targeted therapy is not possible. If the cartilage protective layer is lost, the forces acting are no longer dampened and evenly distributed.

Unfortunately, damage to cartilage cannot be reversed. Ibuprofen, diclofenac or the vegetable frankincense extract H15 have an anti-inflammatory and pain-relieving effect. If these measures no longer help, the pain can be relieved by stiffening. If the mobility of the adjoining finger joints is well preserved, stiffening of the end joint restricts the movement of the entire finger by 10 to 20%.

The used joint is removed via an access of slightly more than one centimetre. The adjacent bone ends are connected with a wire and a metal pin. These then grow together, like after a bone fracture.

How can you prepare for the procedure?

  • All your questions about possible complications and alternative treatments should be answered in advance.
  • Keep nicotine and alcohol consumption to a minimum!
  • Blood-thinning medication (e.g. ASS, Thomapyrin®) must be discontinued at least 10 days before the operation after consultation with your doctor.
  • Vitamin preparations (A, E) and food supplements (omega-3 fatty acids, St. John's wort preparations, etc.) must be discontinued at least 4 weeks before the operation.
  • Surgery limits the ability to travel by air. Therefore, do not plan any professional or private air travel during the 6 weeks after the operation!
  • Lay down ice cubes or cooling pads at home ready to cool the skin after the operation!

How is the procedure performed?

  • The outpatient procedure is performed under local anesthesia and twilight sleep and lasts approx. 45 minutes.

What do you need to keep in mind after the procedure?

  • The raising and cooling of the hand in the first 72 hours is very important.
  • The hand is immobilised by a two-finger wrist splint for 2 weeks and by a finger end splint for another 4 weeks.
  • It is very important that all joints that are not enclosed in the bandage or splint are moved fully several times an hour. The unaffected fingers should be completely closed to the fist and fully stretched again. For painless exercise, ibuprofen, diclofenac or paracetamol tablets can be taken over the counter if required. Please always read the package insert!
  • The skin threads are removed after 10 to 14 days.
  • Postoperative clinical checks are recommended on the 3rd postoperative day and after 1 and 2 weeks.
  • The independent scar massage from the 3rd postoperative week with moisturizing ointment (e.g. Bepanthen® wound and healing ointment, Linola® fat cream) helps to inconspicuous soft scars.
  • X-ray controls without plaster splint are recommended after 6 weeks and finally after 6 months.
  • The small metal pin is usually removed after 6 weeks under local anaesthesia on an outpatient basis.
  • A full load is possible from the 12th postoperative week.

Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

 

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