ABSTRACT
Fusion of the proximal interphalangeal joint (PIPJ) after failed arthroplasty may be challenging in view of bone loss at the ends of the proximal phalanx and the middle phalanx. This might require the use of a structural bone graft to fill the defect and avoid shortening of the digit. Although several methods have been described for primary PIPJ fusion, none of these methods addresses bone loss at this joint. We use a tricortical iliac crest bone graft fashioned to provide the required angulation at the fusion site. A dorsal plate is used to fix the fusion mass and obliquely placed screws provide sequential compression at both ends of the bone graft. We have performed this technique safely in three patients with no complications. Level of Evidence: Level V (Therapeutic).