Arthrodesis of Distal Interphalangeal Joints Using X-Fuse Implant A Five-Year Retrospective Study of 64 Fingers

Abstract

Introduction: Arthrodesis is the gold standard for treating distal interphalangeal arthropathy of the long fingers (IPD) and interphalangeal arthropathy of the thumb (IP). While many surgical techniques have been documented to have high consolidation rates (80–100%), none appeared to be superior to the others. In 2008, the intramedullary X-Fuse implant (Stryker, Switzerland) demonstrated favorable clinical and radiographic outcomes in a limited study with short-term follow-up. Building upon these findings, this study aimed to evaluate the objective and subjective findings of arthrodesis of IPD and IP using the X-Fuse® implant over a medium-term period.

Patients and methods: We retrospectively included 53 patients (49 women and 4 men) who underwent arthrodesis of the IPD or IP joint surgery between May 2012 and January 2021. All surgeries were performed by senior hand surgeons at the same hospital, employing identical surgical techniques. Afterward, patients were immobilized for 6 weeks postoperatively. For analyses, data were extracted from patients’ medical records.

Results: A total of 64 arthrodeses were assessed (with 6 patients lost to follow-up). The average follow-up period was 59.8 (±28) months. The mean QuickDASH score at the last review was 17.1 (±17), and the mean visual analog scale score was 0.64 (±1.6). Notably, more than 90% of patients reported good or excellent satisfaction with the surgery, and radiographic fusion was achieved in over 90% of cases, with an average fusion period of 12.9 weeks (±1.3). However, six cases of pseudarthrosis were documented, with only one requiring revision surgery due to symptoms.

Discussion: X-Fuse® implant arthrodesis yields satisfactory clinical and radiographical outcomes, providing good long-term stability and low complication rates. This technique is considered reliable and reproducible for patients with primary osteoarthritis, inflammatory conditions, and post-traumatic arthropathies.