Effects of serial casting in the treatment of flexion contractures of proximal interphalangeal joints in patients with rheumatoid arthritis and juvenile idiopathic arthritis: A retrospective study

J Hand Ther. 2016 Jan-Mar;29(1):41-50; quiz 50. doi: 10.1016/j.jht.2015.11.005. Epub 2015 Nov 24.

Abstract

Aim: To analyze the effects of serial casting (SC) in the treatment of proximal interphalangeal (PIP) joint flexion contractures in patients with rheumatoid arthritis and juvenile idiopathic arthritis.

Study design: Retrospective case-series.

Methods: The data of 18 patients treated with SC were obtained from their patient records. The angular changes in the finger joints were analyzed and compared statistically using t-tests.

Results: A total of 49 fingers were serially casted with plaster of Paris over a 14-year period. The SC resulted in significant (26.8°; p < 0.001) reduction in the PIP joint extension loss. Small, but statistically significant, losses in flexion were associated with these gains. (p < 0.001). Angular changes were also observed in the other finger joints. The magnitude of the initial extension loss was the only factor to explain the amount of motion gained (p < 0.001; R2 = 0.38).

Conclusion: SC is an effective method to correct flexion contractures in PIP joints in selected patients with arthritis. The gain is partially related to the magnitude of initial extension loss.

Keywords: Arthritis; Flexion contracture; Plaster of Paris; Proximal interphalangeal joint; Serial casting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Juvenile / physiopathology*
  • Arthritis, Rheumatoid / physiopathology*
  • Casts, Surgical*
  • Contracture / physiopathology
  • Contracture / therapy*
  • Female
  • Finger Joint / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Orthotic Devices
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Young Adult