Posttraumatic Arthritis of Dip Joint with Deformity and its
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Post traumatic arthritis of distal interphalangeal joint is a rare condition characterised by pain, tenderness, restriction of movements and deformity. Arthritis in distal interphalangeal joints, if symptomatic are managed with arthrodesis which has good functional outcome though there are recent advances like arthroplasty which has limitation in indications and worst complications associated with it.

A 24 years old male patient right hand dominant student by occupation presented with pain and deformity in right 4th finger for 7 months. The patient had history of fall from two wheeler 7 months back and sustained injury to right finger. The patient had denied any treatment history after the injury. The patient had pain and deformity over the distal part of 4th finger which was gradually progressive for 7 months. On examination the patient had tenderness over the 4th right distal interphalangeal joint with around 80 ulnar deviation of distal phalanx.

The patient had skin contracture over the ulnar side of the joint with thin stretched intact skin dorsally and radially. There was no evidence of infection. The patient had complete restriction of motion with complete motion in middle and proximal interphalangeal joint. The patient expected pain relief and good function as much as possible after the surgery.

Doctors had planned for arthrodesis of distal interphalangeal deformity. After the osteotomy two bone ends were opposed to each other bringing the distal phalanx in line with middle phalanx and fixed with two 1 mm intramedullary k wires. Thus arthrodesis in neutral position had been achieved correcting the deformity without any break in contracture medially.

Postsurgery followup at 3 months patient was absolutely free from pain and completely satisfied with the surgery. Eventhough patient has reduced grip strength compared with normal hand when measured in dynamometer, the patient had good functional outcome compared to preoperative status as evident from the DASH score calculated. The preoperative DASH score was 37.75 which gradually decreased to 18.25, 6th month postoperatively.

Arthrodesis of distal interphalangeal joint with kirschner wires had good union rates and least complication rates than other methods like screws and cerclage wires.

Source: https://www.iomcworld.org/open-access/posttraumatic-arthritis-of-dip-joint-with-deformity-and-its-management-a-casereport.pdf
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