Volar Capsulodesis With Early Active Motion for the Treatment of Chronic Proximal Interphalangeal Joint Hyperextension Deformity.

PURPOSE: We evaluated the clinical outcomes of a series of patients with hyperextension deformity of the proximal interphalangeal joint treated with volar capsulodesis.

METHODS

This retrospective study included 16 patients with symptomatic locking of the proximal interphalangeal joint who underwent volar capsulodesis and were followed for at least 2 years. We excluded patients with severe, degenerative changes on plain radiographs. Clinical evaluation included the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire; Catalano's scale for proximal interphalangeal joint hyperextension deformity correction; a visual analog scale for pain; range of motion; and grip strength. Hyperextension recurrence and residual flexion contracture were also recorded.

RESULTS

There were 2 women and 14 men, with a mean age of 36 years (range, 22-60 years). The mean preoperative pain scores according to the visual analog scale were 3.6 (range,1-8) and 0.5 (range, 0-3) at the final follow-up. No patient had a recurrence of the hyperextension deformity. The average Quick Disabilities of the Arm, Shoulder, and Hand score was 5, and the mean grip strength was 87% of the contralateral side. Five patients were rated as having excellent results, 9 patients as having good results, and 2 patients as having fair results. Residual flexion contracture was less than 10° in 13 patients and more than 10° in 3 cases. All patients returned to unrestricted activities.

CONCLUSION

Volar capsulodesis with early active motion demonstrated favorable results and could be considered as a surgical option for the treatment of chronic hyperextension deformity of the proximal interphalangeal joint.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.