Monday, February 15, 2016

Camptodactyly- bent finger- treatment with splinting

Camptodactyly is the Greek word for bent finger- specifically flexed so that straightening the finger at the middle joint is not possible.  I have blogged about camptodactyly several times before- read those posts HERE and HERE. 

Therapy is the first line treatment for camptodactyly.  And it usually works.  But therapy has its limits and if the finger is too far bent, therapy can not obtain the leverage for splinting.  Typically, fingers bent less than 60 degrees are treated with splinting at least to start.

Here are a few pictures of a 13 yo child with camptodactyly presenting to me for the first time.

Camptodactyly.  The ring finger on both hands is most effected.

Camptodactyly.  The ring finger is most effected.

Camptodactyly demonstrating an ability to make a fist. This ability is preserved.


There are different splinting techniques but I wanted to share our hand- based splint for camptodactyly of the central digits.  The fingers are held in a bent position (through the MP joint) which relaxes tight structures in the fingers such as the tendons.  The tan straps then put pressure on the tight PIP joints as a straightening force.

Camptodactyly hand based splint.  

Camptodactyly hand based splint.  

Camptodactyly hand based splint.  

Camptodactyly hand based splint.  


Charles A. Goldfarb, MD
My Bio at Washington University
congenitalhand@wudosis.wustl.edu




2 comments:

  1. We're bringing our baby boy to see you in May. He is almost 8 weeks old now. From what I can gather, on his right hand only, he has syndactyly of ring and middle fingers and camptodactyly (on the fused fingers). An x-ray shows him to technically have simple complete syndactyly, but the bone at the tip of his middle finger is not fully developed and, as the surgeon said, his joints are not normal in this fingers and he doesn't know if there are tendons, ligaments, and blood vessels for both fingers. I'm not sure how to explain it, but it looks like one extra wide finger with two fingernails, because there is no visible separation between the two fingers on the skin. It also looks like his index finger is missing a bone (or the bone is out of place) so his finger is shorter than it should be. We had an OT make a splint for him last week, and he's worked his way up to wearing it for 4 hours, so tonight he will wear it overnight. It seems to already be making a difference in terms of extension, but those fused fingers are so crooked that, when extended on the splint, the tip touches the tip of the index finger. The fused fingers look almost like a number 7 the way they bend. I wish I could attach pictures to this post. Our OT said once the fingers are extending better, she will probably put a wedge in between the fused fingers and index finger to try to rotate the joints in the right direction. Anyway, the more I chip away at what he has going on with his hand, the more I seem to think that his hand is much more challenging than a simple case of syndactyly. We very much look forward to meeting you and getting your thoughts about what, if anything, you could do to improve the function and appearance of his hand. Thank you!

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    1. Josie. Thank you for the question and I look forward to meeting you and your baby. Feel free to contact me via email (see the blog post- congenitalhand@wudosis.wustl.edu) if you would like to send pictures. It does sound more complicated than the 'typical' syndactyly and your son may benefit from earlier surgery.

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