Finger Deformities

Camptodactyly

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. 

0 Comments

  1. I am also a professional violinist with bent pinkies on both hands. For me, it's a bit of a hindrance to properly placing the finger on the string (the finger contacts the string on the side rather than the tip), and extensions (a technique in violin playing) are quite difficult. Still I have had a long career playing violin professionally, so it hasn't kept me from being able to play.

  2. What happens if I injure my pinkey finger that is affected by this? I have a 90 degree bend in it. Lately I've noticed it getting stiff and shooting pains in it (after I slammed it in a door).

  3. I was born with camptodacaly, from the age of 4 to 12 i had numorous surgeries (at the royal childrens hospital in melbourne australia )to help improve them and the out come making them worse…. i am now 29 and as of late the pain in my right hand pinkie, ring finger and rude finger are begining to become unbearable to the piont i cant sleep at night.
    I no they say that camptodactaly and pain dont go together but i have always had pain but i am at the point i cant deal with it anymore … plz help i dont no what to do??

  4. Hayley, I am sorry to hear about your finger. Sometimes the joints with camptodactyly can develop arthritis and that can be painful. An x-ray would help you understand this better. If there is arthritis and pain, sometimes the joint can be fused (i.e., made stiff) in a functional position- this could eliminate the pain.

  5. Thank you for sharing your expertise in this field! My 8month old daughter has 4 fingers affected, ring finger and pinky on each side, all but one ring finger can be completely extended passively, but that finger has a stretch deficit of around 50-60 degrees when stretched passively and around 90 degrees when extended actively. Now one doc said we should just watch and wait and maybe do a surgery at the age of 2 years, no splints, no therapy. But I had to do something, just to know I tried everything and I went to a physical therapist (no hand therapist available here). And with passive stretching it immediately got a little bit better to ca.30 degrees deficit in passive stretching.
    So I guess continuation of therapy will make sense or does it really make no difference in the long term? How much long term improvement can I realistically expect? Do the other fingers that are bent but sometimes completely extended during play also need any therapy? Can they get worse over time?
    Thank you in advance!

  6. Elisabeth,
    Congratulations on the birth of your daughter. It unusual to have 4 fingers affected with a congenital camptodactyly. I assume that she is otherwise healthy. I am a believer in the value of splinting at night and stretching the fingers during the day. In my experience, it has proven very helpful for families. Ideally, a therapist can make a splint (and unfortunately remake given the rapid growth in hands). Good luck.

  7. theraHi… My cousin is 3 months … We noticed at birth that one fingers on on hand cannot stretch …. Have so far seen an orthopedic, he told us that she needs only excersise but other one told that she needs splint. I want to know if splint is according to age which size is better to her age?

  8. Wafaa,
    Thank you for the question. At this age, stretching is usually the best option for camptodactyly. This means passive stretching, often with each diaper change. Splints can help as well but often we start ing a little older age group.

    Good luck.

  9. hi my pinky finger is like the one in the pic but a bit worser lately my pinky finger has been feeling very sore and stuff it to bend and the knuckle has even went a bit red why is this because in the past my camptodacyly hasnt even bothered me? is there anything i can do now or im i too old for splinting as im 17

  10. My 2 week old son was born with contracture in 3 fingers on the right hand (middle, ring, and pinky fingers). I've been gently stretching the fingers daily and I have noticed improvement in the extension of the fingers. When should I you seek a hand or ortho surgeon for further advice. His pediatrician seems to think that isnt needed right now but I'm thinking the earlier the better. Is it too early for splinting?

  11. KPink,
    Thank you for the question. While it seems as though you and your pediatrician are treating this appropriately, I always like it when I have the chance to be involved at this stage. Stretching alone is great but nighttime splinting can also help. An experience congenital hand surgeon would be recommendation.

  12. Hello, I must say my 3 year old son has the same situation on the picture above. Both his left and right pinky is bent. We just discovered that when he was 5 months old and even the doctors haven't noticed that during well-baby check ups and such. We also tried to consult a surgeon before and he said it needs surgery and best be done when it is younger. I didn't push through that time because I am afraid of the idea of a toddler being done by that. Anyways, when I try to stretch it, I ask him if it hurts and he says no. However, he cannot control his pinkies and it's hard for him to lift his fourth fingers. What should I do? Should I let it be or better to have it treated? He isn't started schooling yet but if ever I will let it be treated, it must be better if it will be done before he goes to school.

  13. Thanks Alima. I strongly believe in therapy which includes stretching (painless as you note) and splinting. This can really help in certain patients. If therapy fails, there is some evidence that early surgery (in a child) is helpful to avoid deformity in the joint which can develop over time. Obviously the decision for surgery is complex and depends on multiple factors including severity of the contracture.

  14. Hello! Thanks so much for the article! I’m 26 years old now and I have had this issue in both my pinkies for as long as I can remember. My right pinky looks exactly like the one in the photo, but my left one is slightly less severe. I’ve always known it was a genetic thing, but to be honest I never realized that people sought treatment/physical therapy for it, because I definitely haven’t! Just figured it was one of those things that made me unique! It’s never really been a hinderance, although it does get sore if I write by hand for too long and I remember when I used to play piano as a kid it was a bit of a struggle to strike the keys repeatedly. Now I’m wondering though if it could potentially lead to arthritis or other issues for me when I’m older? I’m sure my knuckle cracking habit doesn’t help either! Thanks in advanced for your thoughts!

  15. Britni,
    Thank you for the comment. I am happy to hear that the camptodactyly has not been a major hinderance to you- it does depend on the severity. We do know that early, severe camptodactyly can lead to joint changes (ie, arthritis) in younger patients but we do NOT commonly see adults with arthritis related to camptodactyly. I would predict that your fingers should do fine over time. Good luck.

  16. My son is 5 years of age and he has this in both baby fingers only a small bit on his left but very bad on his right, it didn’t seem to bother him too much. He was in the hospital today with a doctor about it and they said they are referring him to a plastic surgeon that specializes it this but that they wouldn’t be able to do anything till he is 7 or 8 and that was it. Nobody has told me of anything I should be or could be doing to help in the mean time. I feel a bit lost about it.

  17. Thank you for your article. My daughter, who is 8 months old, is able to stretch out her pinky fingers but they are always a bit bent when they are at rest. When she grasps at an object, her pinky fingers don’t stretch out at the same rate as the rest of the fingers and end up being bent under the object. Could this be Camptodactyly? Thank you for your time.

  18. Kathy,
    Thank you for the question. Your daughter may have a mild form of camptodactyly. Sometimes this improves with time as the muscles that straighten the fingers (extensors) get stronger. If this does not occur, you might mention to your pediatrician and perhaps therapy will make some sense. This could include a night splint to help stretch the fingers or exercises/ play to strengthen the muscles (all depending on the severity).

    Good luck.

  19. My 10 days old daughter has camptodactyly in both pinkies . We live in a developing country with no much access for the needed specialized health care . Can you recommend more online materials about stretching exercises, being the only thing we can do for her in our conditions .

  20. Maha,
    Thank you. The stretches are quite simple- gentle straightening of the finger with pressure on top of the joint and on the bottom of the finger on either side of the joint (I hope that makes sense- there are 3 points of pressure). And hold this position for about 10 seconds and then let the finger relax. Repeat often (~ 4-5 sessions of 5 minutes each, every day). I hope that makes sense. Good luck.

  21. Dr Goldfarb
    In the past the patient had myotomy of hip adductors and knee/ankle/foot-fingers tenotomy this improved walking and let leg to grow to reach the other one. Is tenotomy and option to hand Camptodactyly in the five fingers of the hand? Are there videos showing excercises? Is there a relation with any Syndrom like Soto's or any other else? Could you recomend some doctor in Mexico City?

  22. Hello,
    First, sometimes cutting a tendon makes sense. So the short answer is yes. The associated diagnosis that first comes to mind is arthrogryposis but, obviously, that is impossible to know for me.
    There are not videos to my knowledge but I agree- that is a good suggestion for the future for this blog. I would go to the Shrine in Mexico City. I know several of the doctors and they do a nice job.

  23. I was born with Camptodactyly in both hands, the right is worse and now I am 53 is starting to cause some issues, ocassional pain and irritation, I have a 10 year old daughter and she has the identical same issue, which is gradually getting worse each year. I am planning to take her in and try splinting maybe I'll see if they can see me at the same time.

  24. Adrian,
    Thank you for the comment. I am glad you have done well for so long. Unfortunately, your finger may not respond to splinting (there could even be arthritis) but may be worth a try. Certainly for your daughter, it will likely make sense. Good luck.

  25. hi RIDI, i am in East Africa – Kenya, my daughter, now 3years old suffer the same and i mean exact condition on both hands, 3 fingers each hand, (index finger and Thumb not affected). we tried splinting for months when she was little to late last year, but each time, we removed the splints the fingers would assume the bent position…. just to encourage you, my daughter has since learnt to use her fingers as they are and she is already learning how to hold a pencil and scribble stuff. she can also hold her bottle as clap … her fingers improved up to around 55% and i think we can live with it. X-Rays confirmed that her finger joints are okay, and i believe that the muscles is what is most affected

  26. I am so glad I found this article. I definitely think this is what I have. My pinky looks exactly like the picture on my right hand. I am 31 years old now and I've noticed this since junior high. I thought maybe I broke my pinky and didn't realize I did but this makes so much sense. I does not bend at the middle at all and when I set my hand down on a flat surface the only finger that bends up is my pinky. Within the last 11 years I started having some irritation with it. I was diagnosed with carpal tunnel syndrome back then and it's gotten so bad I need surgery. Could that be the reason it's hurting? I'm not sure but this gave me a ton of clarity!!

  27. I’ve always had a bent pinky finger, just like the picture. I only noticed as a kid and being from the UK they wouldn’t treat me as it wasn’t an emergency or affecting me.
    Now I’m 30 and living in Korea where I can pay for treatment. Is it treatable or am I a lost cause now?

  28. Halfbloodpixie- thank you for writing. You are correct, at your age, it is less likely that surgery makes sense unless you have pain or unless the finger is getting in the way. And, surgery would be different as an adult. Good luck.

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