Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis
Purpose: Systemic sclerosis (scleroderma) is a chronic autoimmune connective tissue disorder that can lead to notable pain and functional limitations of the digits. This study assessed complications and reoperations after interphalangeal (IP) joint arthrodesis in patients with scleroderma. Methods:...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Hand Surgery Global Online |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589514124001774 |
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| author | Melanie Bertolino, BS Kyra A. Benavent, BS Zachary Li, BS Dafang Zhang, MD Philip E. Blazar, MD Brandon E. Earp, MD |
| author_facet | Melanie Bertolino, BS Kyra A. Benavent, BS Zachary Li, BS Dafang Zhang, MD Philip E. Blazar, MD Brandon E. Earp, MD |
| author_sort | Melanie Bertolino, BS |
| collection | DOAJ |
| description | Purpose: Systemic sclerosis (scleroderma) is a chronic autoimmune connective tissue disorder that can lead to notable pain and functional limitations of the digits. This study assessed complications and reoperations after interphalangeal (IP) joint arthrodesis in patients with scleroderma. Methods: A retrospective review was performed of all patients who underwent digital joint arthrodesis of the proximal IP (PIP), distal IP, or thumb IP joints between September 1, 2006, and December 31, 2019, at an integrated health system comprising two level-I trauma centers and two community teaching hospitals. Six patients who underwent arthrodesis of 13 IP joints were included in the study. Patient demographics, comorbidities, surgical information, and postoperative outcomes were collected from the medical record. Results: Thirteen digits in six patients were treated with digital joint arthrodesis. Three patients had diffuse scleroderma, and four patients were women. The majority of procedures were performed on the PIP joint with Kirshner wires (nine of 13). No patients experienced intraoperative complications. Three patients experienced postoperative complications including flexion deformity, discomfort, and cellulitis. In patients who had primary arthrodesis, two of nine joints went on to nonunion. One patient who underwent arthrodesis of four PIP joints for failed PIP arthroplasties went on to nonunion of all four digits. Of the patients with complications and nonunion, three required reoperation. Conclusions: Our study suggests that arthrodesis is an acceptable treatment option for patients with joint deformities secondary to scleroderma; however, surgeons and patients should be aware of higher rates of complications. Type of study/level of evidence: Therapeutic III. |
| format | Article |
| id | doaj-art-6ddf64f12865433994d0982a8c38df05 |
| institution | Kabale University |
| issn | 2589-5141 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj-art-6ddf64f12865433994d0982a8c38df052025-01-26T05:04:37ZengElsevierJournal of Hand Surgery Global Online2589-51412025-01-017168Outcomes of Joint Arthrodesis in Patients With Systemic SclerosisMelanie Bertolino, BS0Kyra A. Benavent, BS1Zachary Li, BS2Dafang Zhang, MD3Philip E. Blazar, MD4Brandon E. Earp, MD5Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA; Medical University of South Carolina, Charleston, SCDepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA; Tufts University School of Medicine, Boston, MADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA; Harvard Medical School, Boston, MADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA; Harvard Medical School, Boston, MADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA; Harvard Medical School, Boston, MA; Corresponding author: Brandon E. Earp, MD, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02215.Purpose: Systemic sclerosis (scleroderma) is a chronic autoimmune connective tissue disorder that can lead to notable pain and functional limitations of the digits. This study assessed complications and reoperations after interphalangeal (IP) joint arthrodesis in patients with scleroderma. Methods: A retrospective review was performed of all patients who underwent digital joint arthrodesis of the proximal IP (PIP), distal IP, or thumb IP joints between September 1, 2006, and December 31, 2019, at an integrated health system comprising two level-I trauma centers and two community teaching hospitals. Six patients who underwent arthrodesis of 13 IP joints were included in the study. Patient demographics, comorbidities, surgical information, and postoperative outcomes were collected from the medical record. Results: Thirteen digits in six patients were treated with digital joint arthrodesis. Three patients had diffuse scleroderma, and four patients were women. The majority of procedures were performed on the PIP joint with Kirshner wires (nine of 13). No patients experienced intraoperative complications. Three patients experienced postoperative complications including flexion deformity, discomfort, and cellulitis. In patients who had primary arthrodesis, two of nine joints went on to nonunion. One patient who underwent arthrodesis of four PIP joints for failed PIP arthroplasties went on to nonunion of all four digits. Of the patients with complications and nonunion, three required reoperation. Conclusions: Our study suggests that arthrodesis is an acceptable treatment option for patients with joint deformities secondary to scleroderma; however, surgeons and patients should be aware of higher rates of complications. Type of study/level of evidence: Therapeutic III.http://www.sciencedirect.com/science/article/pii/S2589514124001774Hand surgeryInterphalangeal joint fusionJoint arthrodesisSclerodermaSystemic sclerosis |
| spellingShingle | Melanie Bertolino, BS Kyra A. Benavent, BS Zachary Li, BS Dafang Zhang, MD Philip E. Blazar, MD Brandon E. Earp, MD Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis Journal of Hand Surgery Global Online Hand surgery Interphalangeal joint fusion Joint arthrodesis Scleroderma Systemic sclerosis |
| title | Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis |
| title_full | Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis |
| title_fullStr | Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis |
| title_full_unstemmed | Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis |
| title_short | Outcomes of Joint Arthrodesis in Patients With Systemic Sclerosis |
| title_sort | outcomes of joint arthrodesis in patients with systemic sclerosis |
| topic | Hand surgery Interphalangeal joint fusion Joint arthrodesis Scleroderma Systemic sclerosis |
| url | http://www.sciencedirect.com/science/article/pii/S2589514124001774 |
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