Severe camptodactyly: A systematic surgeon and therapist collaboration

J Hand Ther. 2015 Apr-Jun;28(2):167-74; quiz 175. doi: 10.1016/j.jht.2014.12.004. Epub 2014 Dec 13.

Abstract

Introduction: Although common, the treatment of camptodactyly is controversial.

Purpose: Our purpose is to delineate a logical stepwise treatment plan based on corresponding components of the pre-operative and intraoperative evaluation of camptodactyly. In addition, describe structure rehabilitation plan utilizing the same stepwise evaluation.

Methods: With the use of a retrospective cohort study design, we reviewed 18 consecutively operated digits in twelve patients with camptodactyly affecting the proximal interphalangeal (PIP) joint. There were five girls and eight boys, averaging eight years of age (range: 9 months to 15 years) at surgery.

Results: Surgery corrected flexion contractures with mean post-operative flexion contracture of 3° (range 0-25°) at mean follow-up of 11 months (range 3-32 months). 15 of 18 digits achieved full active PIP extension.

Discussion: By employing a detailed clinical assessment to guide surgical treatment followed by focused therapy, we have markedly improved flexion contractures in digits with moderate to severe camptodactyly.

Conclusions: Hand therapy is essential to maintain and further surgical improvement of passive extension and to regain active extension following surgery.

Type of study/level of evidence: Therapeutic IV.

Keywords: Camptodactyly; Flexor contraction resolution; Intrinsic rehabilitation; Operative planning; Relative motion; Stepwise surgery; Technique.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Contracture / etiology
  • Contracture / rehabilitation*
  • Contracture / surgery*
  • Female
  • Finger Joint*
  • Hand Deformities / etiology
  • Hand Deformities / rehabilitation*
  • Hand Deformities / surgery*
  • Hand Strength
  • Humans
  • Infant
  • Male
  • Orthotic Devices
  • Range of Motion, Articular
  • Retrospective Studies
  • Treatment Outcome