Posttraumatic proximal interphalangeal joint flexion contractures.

Published

Journal Article (Review)

Normal motion of the proximal interphalangeal joint requires bony support, intact articular surfaces, unimpeded tendon gliding, and uncompromised integrity of the collateral ligaments and volar plate. Deficiency in any one of these structural requirements can lead to a loss of finger joint motion and decreased hand function. Once finger extension is lost, options include nonsurgical or surgical treatment. Nonsurgical treatment such as splinting or serial casting should be tried before attempting surgical intervention. When severe flexion deformity exists or the vascular status of the finger has been compromised, arthrodesis or amputation should be undertaken instead of procedures to regain motion. Surgical options for regaining motion include external fixators and open surgical release. Although they can lead to improved extension at the proximal interphalangeal joint, external fixators carry a risk of reduced finger flexion and pin site infection. Most clinical series of patients who have undergone surgical release document improvement in flexion contracture between 25 degrees to 30 degrees and a shift of the flexion/extension arc into a more functional range. Close follow-up after surgery is warranted, with frequent physical therapy and splinting.

Full Text

Duke Authors

Cited Authors

  • Hogan, CJ; Nunley, JA

Published Date

  • September 2006

Published In

Volume / Issue

  • 14 / 9

Start / End Page

  • 524 - 533

PubMed ID

  • 16959890

Pubmed Central ID

  • 16959890

International Standard Serial Number (ISSN)

  • 1067-151X

Language

  • eng

Conference Location

  • United States