Arthrodesis is the surgical fusion of a diseased joint for the purposes of obtaining pain relief and stability. The bones are fused in a position permitting most useful function but lose their natural motion.
Shoulder
- Flexion: 30ยฐ
- Abduction: 20ยฐ
- Internal rotation: 40ยฐ
Elbow
- One side: 90ยฐ
- Both side: One in 110ยฐ (feeding) and another is 65ยฐ (perineal hygiene)
Wrist
- Non-rheumatoid: 10-20ยฐ dorsiflexion (power gripping) and neutral radio-ulnar deviation
- Rheumatoid: Neutral or flexed with 5-10ยฐ ulnar deviation (hygiene and perineal care are easier)
Hand
Fingers | MCP | PIP | DIP |
Index | 25 | 40 | 10 |
Middle | 30 | 45 | 10 |
Ring | 35 | 50 | 10 |
Little | 40 | 55 | 10 |
Thumb
- CMC joint: 45ยฐ palmar abduction and 20ยฐ radial abduction (manual workers)/30-40ยฐ radial abduction (women)
- MCP joint: 10-20ยฐ flexion, 20ยฐ pronation, 20ยฐ abduction
- IP joint: 0-15ยฐ flexion

Hip
- Flexion: 25-30ยฐ
- Abduction: 0ยฐ
- Rotation: 0ยฐ
Knee
- Flexion: 10-15ยฐ
- Valgus: 0-7ยฐ
- External rotation: 10ยฐ
Ankle
- Hindfoot valgus: 5ยฐ
- External rotation: 5-10ยฐ
- Dorsiflexion: Neutral
- Talus: Posterior
If the ankle is fused in varus, the supinated foot becomes rigid and does not adapt to the ground during the second rocker phase. The lever arm of the foot becomes too long and impairs the third rocker phase if the talus is fused in an anterior position.
Subtalar
- Dorsiflexion: Neutral
- Heel valgus: 10ยฐ
Talonavicular
- Neutral dorsi/plantarflexion
Calcaneocuboid
- Heel valgus: 10ยฐ
- Forefoot ad/abduction and prono-supination: Neutral
Talonavicular joint should be fixed before calcaneocuboid joint during a triple arthrodesis.
1st great toe MTP
- Valgus: 15-20ยฐ
- Dorsiflexion: 10-15ยฐ
- Rotation: Neutral
Acronyms:
- CMC: Carpometacarpal
- MCP: Metacarpophalangeal
- PIP: Proximal interphalangeal
- DIP: Distal interphalangeal
- IP: Interphalangeal
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