Severe camptodactyly: A systematic surgeon and therapist collaboration.

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.