- Dorsal approach to the DIP joint

Indications
This approach is indicated for an arthrodesis of a painful flexion contracture of the DIP joint.
Posttraumatic malunion with joint degeneration is another good indication for this approach.
In a combined procedure, a longitudinal incision may be a better choice as it allows for a possible extension.

Anatomy
The veins are superficial and should be preserved, especially those running in the long axis of the toe. The arteries and the nerves are basically situated on the medial and lateral aspects of the toe.

Incision
Make a transverse incision over the DIP joint. Take care not to extend the incision over the lateral aspect of the toe so as not to harm the collateral nerves.

Exposure
This incision gives a good view of the extensor tendon.