Camptodactyly is the position of flexion of the proximal
interphalangeal (PIP) joint. Translated from Greek, camptodactyly means “bent
finger.” It may be first noted in
the newborn, as a congenital camptodactyly, or it may present or progress in
adolescence. There are a
number of anatomical structures that have been described as “causing”
camptodactyly including abnormal muscle and tendon insertions. Additionally, camptodactyly may results
from weak muscle extension power at the PIP joint or may be a part of a larger
syndrome such as arthrogryposis.
There are no easy answers for camptodactyly but treatment
starts with therapy. Extension
splinting at night (a static or resting splint) and more aggressive splinting
during the day (dynamic or static progressive splinting) may be helpful. Surgery does not provide an easy
answer and the results may be disappointing to both surgeon and patient. The position of the joint can usually
be improved but almost never can it be made normal. Surgery can also help with therapy by taking a joint that
had been difficult to splint and making splinting possible. Surgery usually consists of releasing
any abnormal structures that may be limiting PIP joint extension, possibly
release the tight joint itself, and possibly moving tendons to increase the
strength of extension of the PIP joint.
One of the risks of
surgery that worries the surgeon is the loss of ability to fully bend the
finger.
 |
| Camptodactyly of small finger PIP joint. Adolescent type. Patient is attempting to straighten small finger. |
treatment is difficult either conservative or operative.but if extension loss is less than 60% conservative is better because of poor result and stiffness associated with operative management.
ReplyDeleteThanks for the comment. I agree that treatment for camptodactyly is a challenge. Mild deformity can often be treated with success using splints alone. Moderate or severe deformity are indeed difficult with nonsurgical care or surgery.
DeleteThis sounds exactly what my baby daughter was born with. What's the first step that I should take to begin her treatment?
ReplyDeleteThe first step is to find a congenital hand specialist to confirm the diagnosis and initiate treatment. Stretching is likely to be recommended and sometimes splinting. Early initiation of these treatments has a good chance of being helpful.
ReplyDeleteThis looks exactly like what my son has also. On 6 fingers. 3 fingers each hand. (the index finger and thumb of both hands are not affected) I saw 1 hand specialists, pediatric hand surgeon and a hand surgeon (when we lived in Kansas) from the time he was born to 18 months. None of them knew what it was and said to wait untill he's a bit older, none suggested splinting even though my son's left hand seems more affected and the fingers are really bent. A fourth specialist said that this looks like it could be camptodactyly, said surgery doesn't help much and may even injure his nerves, then he referred me back to the peadiatric hand surgeon.
ReplyDeleteWe have since then moved to East Africa and have not seen any more specialists. My son is now 3. I stretch his hands gently when he's asleep. Is there something else I should be doing? Is splinting still an option?
Both my left and right little fingers are bent. However, at age 4 1/2, I started playing the piano and my right little finger improve dramatically (it is maybe now only bent 10%). Since I only started playing with my left hand later, my left little finger only improve to 50%.
DeleteThis to say that a splint might still be an option for your son at age 3.
Good luck!
I appreciate your comments and this can be a confusing diagnosis. In principle, I agree with stretching and typically recommend stretching 3-4 times/ day for a few minutes each session. Obviously not to the point of pain. Splinting might be an option but difficult to confirm without clinic visit and x-rays. Good luck.
ReplyDeleteThis is what I have on my right hand, my small finger looks just like the picture above. I am 21 and was diagnosed with this abnormality when I was around the age of 16. On my left hand I have another abnormality in my small finger. My small finger does not bend at the middle joint but instead stays straight, when my hand is laid flat it looks normal, but when I make a fist my finger stays mostly straight except for the top joint near the tip of my finger and the joint near the base of my finger. When I saw the doctor he didn't have much to say about the left hand small finger other than it was a frozen joint. Is there a more technical term for this or is it similar or at all related to Camptodactyly?
ReplyDeleteThe left small finger is likely something called symphalangism, although this is just my educated guess. Symphalangism is the failure of the joint to develop normally. There are other possibilities for sure to explain your difficulty including a simple lack development of a joint.
Deletehave a nice day ,I am a physiotherapy student in Poland ,may I know what is your best solution ,to solve captodactyly ,how ever the result would be deppend on the time that how early we diagnose such syndrome ,splinting ,electrical machines or even casting could be well to avoid deveolp or even cure !?
ReplyDeleteThank you. I believe in splinting and even serial casting for most patients with camptodactyly. I do agree that younger patients may respond better. However, these treatments do not cure the problem, only (hopefully) make it better.
DeleteI have this condition in my right hand and it's never been a problem although the other middle joints have always been a bit larger in my right hand. In the last few years I've started experiencing some arthritis like symptoms. I have rock climbed on and off for 20+ years and do many other activities but there's an increasing recovery period from pain and stiffness in that hand. I'm 49 so some of this the symptoms might just be age related or is this a pretty standard progression?
ReplyDeleteThank you for posting. Your symptoms could be arthritis as some types of camptodactyly seem more prone to develop joint problems such as arthritis. The joint mechanics are also abnormal in camptodactyly, increasing the risk of difficulties. Bottom line is that if the finger is bothering you enough, a hand surgeon consultation with x-rays makes sense.
ReplyDeleteI think I might have this, but I've never received any kind of therapy for it. It's very slight and isn't nearly as noticeable as the photo above. It's also never hindered me in any way, except that sometimes when I need to have my hands flat against a surface for an extended period of time (when I am washing my car, for example) my pinkie finger starts to hurt because of the strain. I first noticed it in kindergarten when my teacher tried to press my hand flat against a paper so she could trace it for me and my pinkie wouldn't lay flat. She kept trying to force it down (it hurt) and that was when I wondered if there was something wrong. Are there different types of camptodactyly that are less severe than others? It never even occurred to me that this is something that people would get therapy for, because it's never been a problem. I was just curious to find out why my finger couldn't straighten out all the way. I know of other members of my family who have it too, but I'm not sure how severely they may have it.
ReplyDeleteJane, thanks for your comment. You are absolutely correct in that the severity varies for camptodactyly. Obviously, I can't be certain of your diagnosis but seems quite possible that you have a mild camptodactyly. The fact that it hasn't worsened is great and means it likely will not get worse later (assuming you are fully grown- adolescent growth spurts can be associated with worsening). In patients with a mild deformity that doesn't interfere with activities, I rarely recommend even therapy.
DeleteHello Charles,
ReplyDeleteI read this information and I agree completely with you.
I have camptodactyly in my both hands ( pinky fingers).
It has been worrying me. So I had a plastic surgery to my right pinky when i was 21. I feel like the doctor has not made the operation good.. Now I am not able to bend my pinky finger. It is slightly better than before in looks but I am not able to bend completely ..It is worse.. I need help of 4th finger to touch the palm. What is the reason? Can I get do further treatments to make it normal? I am experiencing difficulties to bend it.. It also pains.. sometimes the pain extends to whole right hand!,, I need help. i hope i can still make it completely alright or atleast make it to bend!
Thanks in advance!
Sorry to hear about your difficulty, unfortunately, it is not uncommon to hear. Camptodactyly surgery can sometimes cause more problems than the camptodactyly itself. That is why most surgeons who treat this believe that therapy to include splinting is the best treatment. If therapy is not successful, then surgery is considered.
ReplyDeleteI always worry that patients I treat could lose the ability to bend the finger fully. Sometimes the finger becomes stiff and straight but it sounds like your situation is different- you can bend the finger (passive motion) but it just won't completely bend on its own (active motion). Therapy may be able to help as adhesions around the flexor tendons are the most likely cause. Good luck!