Joint Fusion (Arthrodesis) of Finger or Thumb Joints

Through an incision over the affected joint, the remaining damaged cartilage is removed and the joint surfaces are held together with screws, plates or wires until they fuse into a single, solid piece of bone. The procedure typically takes one to two hours, depending on how many joints are involved, and is usually day surgery.

Assessment includes examination and X-rays to confirm the severity of joint damage and discuss which joints would benefit from fusion versus other treatment. Standard preoperative steps apply, including fasting and arranging transport home.

A splint or cast protects the joint while it fuses, generally worn for several weeks. Hand therapy focuses on maintaining movement in the surrounding, unfused joints and adapting hand function to the new joint position. Full fusion and recovery generally takes a few months.

Rehabilitation focuses on maximising movement and strength in the surrounding joints, since the fused joint itself will not regain movement. Hand therapy also helps patients adapt grip and pinch patterns to work well with the fused joint.

Risks include infection, and, though uncommon, the bones failing to fuse together (nonunion), which may need further surgery. Some patients experience reduced hand function from the loss of movement at the fused joint, though this is generally an accepted trade-off for pain relief.

The aim is reliable, lasting pain relief at a joint too damaged to be helped by other treatments. Most patients experience good pain relief and improved stability, with the trade-off being permanent loss of movement at the specific fused joint, which most people find an acceptable exchange for a pain-free, stable digit.

Joint fusion sacrifices movement at a severely arthritic finger or thumb joint in exchange for reliable, lasting pain relief and improved stability. Most patients find the trade-off worthwhile when the joint was significantly limiting hand use beforehand.