Comparative study between tension band and compression screw fixation in metacarpophalangeal and proximal interphalangeal joint arthrodesis
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Published:
Nov 18, 2020
Keywords:
Arthrodesis, proximal interphalangeal and metacarpophalangeal joint fusion, tension band, compression screw
Main Article Content
Abstract
Abstract
Introduction: Tension band wiring (TBW) and compression screw fixation are the most common methods used for proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint arthrodesis. The aim of this study was to compare outcomes between patients treated with those methods. Materials and Methods: A 10-year retrospective comparative study. The study population included skeletally mature patients treated for osteoarthritis or arthritis. Union rates, healing times, complications, and reoperation rates were compared between TBW and compression screw fixation methods. Outcomes were also studied in terms of rheumatic and nonrheumatic patients. Results: The study sample consisted of 56 cases and 44 patients (average age, 53 years). Group 1: 35 patients treated with TBW. Group 2: 21 patients treated with compression screw fixation. There were 32 rheumatic cases and 24 nonrheumatic cases. The average follow-up was 24 months. Union rates were 94.2% (Group 1) and 85,7% (Group 2). Complication rates were 11.4% (Group 1) and 23.8% (Group 2). Reoperation rates were 17.1% (Group 1) and 0% (Group 2). Conclusions: Both methods have high union rates; however, the nonunion incidence in the compression screw group was almost three times higher than in the TBW group. The reoperation rate was higher in the TBW group, mostly due to hardware removal. Healing time was shorter in non-rheumatic patients regardless of the method.
Key words: Arthrodesis; proximal interphalangeal and metacarpophalangeal joint fusion; tension band; compression screw.
Level of Evidence: III
Introduction: Tension band wiring (TBW) and compression screw fixation are the most common methods used for proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint arthrodesis. The aim of this study was to compare outcomes between patients treated with those methods. Materials and Methods: A 10-year retrospective comparative study. The study population included skeletally mature patients treated for osteoarthritis or arthritis. Union rates, healing times, complications, and reoperation rates were compared between TBW and compression screw fixation methods. Outcomes were also studied in terms of rheumatic and nonrheumatic patients. Results: The study sample consisted of 56 cases and 44 patients (average age, 53 years). Group 1: 35 patients treated with TBW. Group 2: 21 patients treated with compression screw fixation. There were 32 rheumatic cases and 24 nonrheumatic cases. The average follow-up was 24 months. Union rates were 94.2% (Group 1) and 85,7% (Group 2). Complication rates were 11.4% (Group 1) and 23.8% (Group 2). Reoperation rates were 17.1% (Group 1) and 0% (Group 2). Conclusions: Both methods have high union rates; however, the nonunion incidence in the compression screw group was almost three times higher than in the TBW group. The reoperation rate was higher in the TBW group, mostly due to hardware removal. Healing time was shorter in non-rheumatic patients regardless of the method.
Key words: Arthrodesis; proximal interphalangeal and metacarpophalangeal joint fusion; tension band; compression screw.
Level of Evidence: III
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Bennice, J., Gallucci, G. L., Zaidenberg, E. E., De Carli, P., & Boretto, J. G. (2020). Comparative study between tension band and compression screw fixation in metacarpophalangeal and proximal interphalangeal joint arthrodesis. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(4), 325-334. https://doi.org/10.15417/issn.1852-7434.2020.85.4.1063
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Clinical Research
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References
1. Jung J, Haghverdian B, Gupta R. Proximal interphalangeal joint fusion: indications and techniques. Hand Clin
2018;34(2):177-84. https://doi.org/10.1016/j.hcl.2017.12.007
2. Yamamoto M, Chung KC. Joint fusion and arthroplasty in the hand. Clin Plast Surg 2019;46(3):479-88.
https://doi.org/10.1016/j.cps.2019.03.008
3. Sennwald G, Segmuller G. The metacarpo-phalangeal arthrodesis of the thumb according to the tension-band
principle: indications and technique. Ann Chir Main 1983;2(1):38-45. https://doi.org/10.1016/s0753-9053(83)80078-7
4. Leibovic SJ. Proximal interphalangeal joint arthritis. En: Chhabra B, Isaacs J, eds. Arthritis and arthroplasty: The
hand, wrist, and elbow. Philadelphia, PA: Elsevier Inc.; 2010:142-54.
5. Breyer JM, Vergara P, Parra L, Sotelo P, Bifani A, Andrade F. Metacarpophalangeal and interphalangeal joint
arthrodesis: a comparative study between tension band and compression screw fixation. J Hand Surg Eur
2015;40(4):374-8. https://doi.org/10.1177/1753193413514362
6. Herren D. The proximal interphalangeal joint: arthritis and deformity. EFORT Open Rev 2019;4(6):254-62.
https://doi.org/10.1302/2058-5241.4.180042
7. Uhl RL. Proximal interphalangeal joint arthrodesis using the tension band technique. J Hand Surg Am 2007;32(6):914-7. https://doi.org/10.1016/j.jhsa.2007.04.014
8. Leibovic SJ. Instructional Course Lecture. Arthrodesis of the interphalangeal joints with headless compression
screws. J Hand Surg Am 2007;32:1113-9. https://doi.org/10.1016/j.jhsa.2007.06.010
9. Hogh J, Jensen PO. Compression-arthrodesis of finger joints using Kirschner wires and cerclage. Hand 1982;14(2):149-52. https://doi.org/10.1016/s0072-968x(82)80006-5
10. Hohendorff B, Franke J, Spies CK, Muller LP, Ries C. Arthrodesis of the proximal interphalangeal joint of fingers with tension band wire. Oper Orthop Traumatol 2017;29(5):385-94. https://doi.org/10.1007/s00064-016-0471-7
11. Khuri SM. Tension band arthrodesis in the hand. J Hand Surg Am 1986;11(1):41-5.
https://doi.org/10.1016/s0363-5023(86)80099-5
12. Stern PJ, Gates NT, Jones TB. Tension band arthrodesis of small joints in the hand. J Hand Surg Am 1993;18:194-7. https://doi.org/10.1016/0363-5023(93)90344-3
13. Uhl RL, Schneider LH. Tension band arthrodesis of finger joints: a retrospective review of 76 consecutive cases. J Hand Surg Am 1992;17:518-22. https://doi.org/10.1016/0363-5023(92)90365-v
14. Adla DN, Kitsis C, Miles AW. Compression forces generated by mini bone screws: a comparative study done on bone model. Injury 2005;36:65-70. https://doi.org/10.1016/j.injury.2004.03.026
15. Ayres JR, Goldstrohm GL, Miller GJ, Dell PC. Proximal interphalangeal joint arthrodesis with the Herbert screw.
J Hand Surg Am 1988;13(4):600-3. https://doi.org/10.1016/s0363-5023(88)80105-9
16. Katzman SS, Gibeault JD, Dickson K, Thompson JD. Use of a Herbert screw for interphalangeal joint arthrodesis. Clin Orthop Relat Res 1993;(296):127-32. PMID: 8222414
17. Newman EA, Orbay MC, Nunez FA Jr, Nunez F. Minimally invasive proximal interphalangeal joint arthrodesis
using headless screw: surgical technique. Tech Hand Surg 2018;22:39-42.
https://doi.org/10.1097/BTH.0000000000000189
18. Teoh LC, Yeo SJ, Singh I. Interphalangeal joint arthrodesis with oblique placement of an AO lag screw. J Hand Surg Br 1994;19(2):208-11. https://doi.org/10.1016/0266-7681(94)90168-6
19. Capo JT, Melamed E, Shamian B, Hadley SR, Ng Lai W, Gerszberg K, et al. Biomechanical evaluation of 5 fixation devices for proximal interphalangeal joint arthrodesis. J Hand Surg Am 2014; 39(10):1971-7.
https://doi.org/10.1016/j.jhsa.2014.07.035
20. Millrose M, Zach A, Kim S, Guthoff C, Eisenschenk A, Vonderlind HC. Biomechanical comparison of the proximal interphalangeal joint arthrodesis using a compression wire. Arch Orthop Trauma Surg 2019;139(4):577-81. https://doi.org/10.1007/s00402-019-03119-5
21. Vonderlind HC, Zach A, Eichenauer F, Kim S, Eisenschenk A, Millrose M. Proximal interphalangeal joint
arthrodesis using a compression wire: A comparative biomechanical study. Hand Surg Rehabil 2019;38(5):307-11.
https://doi.org/10.1016/j.hansur.2019.07.002
22. Alluri RK, Hill JR, Navo P, Ghiassi A, Stevanovic A, Mostofi A. Washer and post augmentation of 90/90 wiring for proximal interphalangeal joint arthrodesis: A biomechanical study. J Hand Surg Am 2018;43(12):1137.
https://doi.org/10.1016/j.jhsa.2018.04.010
23. Mittelmeier W, Lehner S, Gollwitzer H, Hauschild M, Werber KD, Steinhauser E. Comparing biomechanical
investigations about different wiring techniques of finger joint arthrodesis. Arch Orthop Trauma Surg 2005;125:
145-52. https://doi.org/10.1007/s00402-004-0773-3
24. Ijsselstein CB, van Egmond DB, Hovius SE, van der Meulen JC. Results of small-joint arthrodesis: comparison of Kirschner wire fixation with tension band wire technique. J Hand Surg Am 1992;17(5):952-6.
https://doi.org/10.1016/0363-5023(92)90476-6
25. Leibovic SJ, Strickland JW. Arthrodesis of the proximal interphalangeal joint of the finger: comparison of the use of the Herbert screw with other fixation methods. J Hand Surg Am 1994;19(2):181-8.
https://doi.org/10.1016/0363-5023(94)90002-7
26. Beldner S, Polatsch DB. Arthrodesis of the metacarpophalangeal and interphalangeal joints of the hand: Current concepts. J Am Acad Orthop Surg 2016;24(5):290-7. https://doi.org/10.5435/JAAOS-D-15-00033
27. Satteson ES, Langford MA, Li Z. The management of complications of small joint arthrodesis and arthroplasty.
Hand Clin 2015;31(2):243-66. https://doi.org/10.1016/j.hcl.2015.01.002
28. Stanley JK, Smith EJ, Muirhead AG. Arthrodesis of the metacarpo-phalangeal joint of the thumb: a review of 42
cases. J Hand Surg Br 1989;14(3):291-3. https://doi.org/10.1016/0363-5023(94)90002-7
2018;34(2):177-84. https://doi.org/10.1016/j.hcl.2017.12.007
2. Yamamoto M, Chung KC. Joint fusion and arthroplasty in the hand. Clin Plast Surg 2019;46(3):479-88.
https://doi.org/10.1016/j.cps.2019.03.008
3. Sennwald G, Segmuller G. The metacarpo-phalangeal arthrodesis of the thumb according to the tension-band
principle: indications and technique. Ann Chir Main 1983;2(1):38-45. https://doi.org/10.1016/s0753-9053(83)80078-7
4. Leibovic SJ. Proximal interphalangeal joint arthritis. En: Chhabra B, Isaacs J, eds. Arthritis and arthroplasty: The
hand, wrist, and elbow. Philadelphia, PA: Elsevier Inc.; 2010:142-54.
5. Breyer JM, Vergara P, Parra L, Sotelo P, Bifani A, Andrade F. Metacarpophalangeal and interphalangeal joint
arthrodesis: a comparative study between tension band and compression screw fixation. J Hand Surg Eur
2015;40(4):374-8. https://doi.org/10.1177/1753193413514362
6. Herren D. The proximal interphalangeal joint: arthritis and deformity. EFORT Open Rev 2019;4(6):254-62.
https://doi.org/10.1302/2058-5241.4.180042
7. Uhl RL. Proximal interphalangeal joint arthrodesis using the tension band technique. J Hand Surg Am 2007;32(6):914-7. https://doi.org/10.1016/j.jhsa.2007.04.014
8. Leibovic SJ. Instructional Course Lecture. Arthrodesis of the interphalangeal joints with headless compression
screws. J Hand Surg Am 2007;32:1113-9. https://doi.org/10.1016/j.jhsa.2007.06.010
9. Hogh J, Jensen PO. Compression-arthrodesis of finger joints using Kirschner wires and cerclage. Hand 1982;14(2):149-52. https://doi.org/10.1016/s0072-968x(82)80006-5
10. Hohendorff B, Franke J, Spies CK, Muller LP, Ries C. Arthrodesis of the proximal interphalangeal joint of fingers with tension band wire. Oper Orthop Traumatol 2017;29(5):385-94. https://doi.org/10.1007/s00064-016-0471-7
11. Khuri SM. Tension band arthrodesis in the hand. J Hand Surg Am 1986;11(1):41-5.
https://doi.org/10.1016/s0363-5023(86)80099-5
12. Stern PJ, Gates NT, Jones TB. Tension band arthrodesis of small joints in the hand. J Hand Surg Am 1993;18:194-7. https://doi.org/10.1016/0363-5023(93)90344-3
13. Uhl RL, Schneider LH. Tension band arthrodesis of finger joints: a retrospective review of 76 consecutive cases. J Hand Surg Am 1992;17:518-22. https://doi.org/10.1016/0363-5023(92)90365-v
14. Adla DN, Kitsis C, Miles AW. Compression forces generated by mini bone screws: a comparative study done on bone model. Injury 2005;36:65-70. https://doi.org/10.1016/j.injury.2004.03.026
15. Ayres JR, Goldstrohm GL, Miller GJ, Dell PC. Proximal interphalangeal joint arthrodesis with the Herbert screw.
J Hand Surg Am 1988;13(4):600-3. https://doi.org/10.1016/s0363-5023(88)80105-9
16. Katzman SS, Gibeault JD, Dickson K, Thompson JD. Use of a Herbert screw for interphalangeal joint arthrodesis. Clin Orthop Relat Res 1993;(296):127-32. PMID: 8222414
17. Newman EA, Orbay MC, Nunez FA Jr, Nunez F. Minimally invasive proximal interphalangeal joint arthrodesis
using headless screw: surgical technique. Tech Hand Surg 2018;22:39-42.
https://doi.org/10.1097/BTH.0000000000000189
18. Teoh LC, Yeo SJ, Singh I. Interphalangeal joint arthrodesis with oblique placement of an AO lag screw. J Hand Surg Br 1994;19(2):208-11. https://doi.org/10.1016/0266-7681(94)90168-6
19. Capo JT, Melamed E, Shamian B, Hadley SR, Ng Lai W, Gerszberg K, et al. Biomechanical evaluation of 5 fixation devices for proximal interphalangeal joint arthrodesis. J Hand Surg Am 2014; 39(10):1971-7.
https://doi.org/10.1016/j.jhsa.2014.07.035
20. Millrose M, Zach A, Kim S, Guthoff C, Eisenschenk A, Vonderlind HC. Biomechanical comparison of the proximal interphalangeal joint arthrodesis using a compression wire. Arch Orthop Trauma Surg 2019;139(4):577-81. https://doi.org/10.1007/s00402-019-03119-5
21. Vonderlind HC, Zach A, Eichenauer F, Kim S, Eisenschenk A, Millrose M. Proximal interphalangeal joint
arthrodesis using a compression wire: A comparative biomechanical study. Hand Surg Rehabil 2019;38(5):307-11.
https://doi.org/10.1016/j.hansur.2019.07.002
22. Alluri RK, Hill JR, Navo P, Ghiassi A, Stevanovic A, Mostofi A. Washer and post augmentation of 90/90 wiring for proximal interphalangeal joint arthrodesis: A biomechanical study. J Hand Surg Am 2018;43(12):1137.
https://doi.org/10.1016/j.jhsa.2018.04.010
23. Mittelmeier W, Lehner S, Gollwitzer H, Hauschild M, Werber KD, Steinhauser E. Comparing biomechanical
investigations about different wiring techniques of finger joint arthrodesis. Arch Orthop Trauma Surg 2005;125:
145-52. https://doi.org/10.1007/s00402-004-0773-3
24. Ijsselstein CB, van Egmond DB, Hovius SE, van der Meulen JC. Results of small-joint arthrodesis: comparison of Kirschner wire fixation with tension band wire technique. J Hand Surg Am 1992;17(5):952-6.
https://doi.org/10.1016/0363-5023(92)90476-6
25. Leibovic SJ, Strickland JW. Arthrodesis of the proximal interphalangeal joint of the finger: comparison of the use of the Herbert screw with other fixation methods. J Hand Surg Am 1994;19(2):181-8.
https://doi.org/10.1016/0363-5023(94)90002-7
26. Beldner S, Polatsch DB. Arthrodesis of the metacarpophalangeal and interphalangeal joints of the hand: Current concepts. J Am Acad Orthop Surg 2016;24(5):290-7. https://doi.org/10.5435/JAAOS-D-15-00033
27. Satteson ES, Langford MA, Li Z. The management of complications of small joint arthrodesis and arthroplasty.
Hand Clin 2015;31(2):243-66. https://doi.org/10.1016/j.hcl.2015.01.002
28. Stanley JK, Smith EJ, Muirhead AG. Arthrodesis of the metacarpo-phalangeal joint of the thumb: a review of 42
cases. J Hand Surg Br 1989;14(3):291-3. https://doi.org/10.1016/0363-5023(94)90002-7