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Arthrodesis Positions

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

Elbow

Wrist

Hand

FingersMCPPIPDIP
Index254010
Middle304510
Ring355010
Little405510
MCP is preferably not fused because the arc of motion is initiated here

Thumb

  1. CMC joint: 45° palmar abduction and 20° radial abduction (manual workers)/30-40° radial abduction (women)
  2. MCP joint: 10-20° flexion, 20° pronation, 20° abduction
  3. IP joint: 0-15° flexion
Source: Miller’s Orthopedics

Hip

Knee

Ankle

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

Talonavicular

Calcaneocuboid

Talonavicular joint should be fixed before calcaneocuboid joint during a triple arthrodesis.

1st great toe MTP


Acronyms:

  1. CMC: Carpometacarpal
  2. MCP: Metacarpophalangeal
  3. PIP: Proximal interphalangeal
  4. DIP: Distal interphalangeal
  5. IP: Interphalangeal
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