|Camptodactyly of small finger PIP joint. Adolescent type. |
Patient is attempting to straighten small finger.
Tuesday, March 27, 2012
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.