The proximal interphalangeal joint in Dupuytren's disease.

A precise excision of the diseased fascia corrects proximal interphalangeal joint deformity in many instances. When excision of the fascia results in a contracture of greater than 30 degrees that has not been corrected to this level by gentle manipulation, then a systematic release of the causative structures is occasionally indicated, paying particular attention to the check rein ligaments of the palmar plate and adherence of shortened collateral and accessory collateral ligaments. Postoperative physical therapy and splinting are necessary, particularly in those cases in which a joint release has been performed. These authors advise against a routine joint release. Ultimately, the failure to regain flexion may be a greater disability than the original loss of extension.