Arthritis of Fingers
The most common cause for arthritis of the fingers is again that of osteoarthritis. This is classically seen in the distal joints within the respective fingers, i.e., the one closest to the nails. Typical findings include deformity, angulation of the finger as well as cysts, i.e., mucous cysts which emanate from the joint. This causes deformity of the adjacent nail plate as well. Initial treatment is conservative which includes that of aspiration of the cyst, anti-inflammatories and/or splinting. If this is not successful, surgery which includes debridement of the joint can be done under local anesthesia.
This involves debridement of bone spurs and removal of the inflammatory tissues as well as cystic material. Often this will allow new growth of a normal nail plate. If destruction of the joint is too great to allow this, then arthrodesis or fusion of the joint is warranted. Although this causes total elimination of motion at that joint, it is reliable in relieving pain. Typically the joint is fused utilizing 2 pins as well as an interosseous wire. These pins stay in for approximately 8 weeks and are removed in the office under local anesthesia. During this time period, the joint that is fused is protected with a splint. Motion in the more proximal joints, i.e., the knuckle closest to the hand, is allowed immediately such that the finger doesn't become stiff.