"Pepper-pot" arthrodesis of the small joints of the hand: our experience in 68 cases.

Sixty-eight small joint arthrodeses were performed in the hand using a new technique. Following removal of the articular cartilage, multiple drill holes are made through the subchondral bone, connecting the medullary canal with the joint space. The final joint position is maintained with an intraosseous wire loop and a Kirschner wire. Union was achieved at a mean of 7 weeks and our results are comparable with those of other series. This technique is easy to perform but is contraindicated if there is extreme joint destruction. Its main advantages are that the position of the fusion can be adjusted as bone-to-bone congruency is maintained through an arc of flexion and the overall length and shape of the digit is preserved.