Distal Interphalangeal Joint Arthrodesis: Retrospective Review and Comparative Analysis of Compression Screws

BACKGROUND: Distal interphalangeal joint (DIPJ) osteoarthritis is a frequent and disabling condition commonly treated with arthrodesis. Traditional fixation methods include headless compression screws (HCSs) and angled compression screws (ACSs), but newly developed snap-off compression pins (SCPs) offer a low-profile alternative. This study compares outcomes of DIPJ arthrodesis using HCS, ACS, and SCP fixation. METHODS: A retrospective review of DIPJ arthrodesis patients using SCP, HCS, and ACS implants was conducted. Patients aged 18 to 89 years were eligible for inclusion. Those with a proximal interphalangeal joint (PIPJ) arthrodesis or multiple traumas to the ipsilateral arm. The primary outcome was Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores at final follow-up, with baseline scores reported for context. Secondary outcomes were peri- and postoperative factors including operative time, tourniquet time, complications, and rate of additional surgeries. RESULTS: A total of 149 fusions were analyzed in the study: 18 in the SCP, 112 in the HCS, and 19 in the ACS groups. Baseline characteristics were similar between all groups. The average final QuickDASH score was significantly improved from baseline for the SCP and HCS group, but not for the ACS group. The complication profiles and rates for additional surgery were comparable between all 3 cohorts. Average operative and tourniquet times were comparable between all groups as well. CONCLUSION: Patient-reported outcomes, complications, and additional surgery rates in DIPJ arthrodesis patients treated with SCP are comparable with those in patients treated with HCS or ACS. Snap-off compression pins are therefore a viable option for DIPJ arthrodesis.