Arthrogryposis Finger Deformities

Mild Camptodactyly

Camptodactyly comes in different types based on age and severity.  I have written several times about camptodactyly including http://congenitalhand.wustl.edu/2012/03/camptodactyly.html

While there are different ways to consider camptodactyly, there are three basic types: infantile, adolescent, and camptodactyly associated with a syndrome (i.e., athrogryposis, etc.).  For most patients, camptodactyly affects the small fingers on both sides but may be different on each side.  Syndromic kids may have any finger affected.  When, for example, the long finger is affected, it tends to be more of a problem compared to the small finger and get in the way of grasp.  Upton and others have done a nice job breaking down these 3 types with the results of treatment.  http://www.ncbi.nlm.nih.gov/pubmed/7814601

I certainly see all three types of camptodactyly patients and each has its challenges.  Pain is rare but with a worsening deformity (i.e., worsening position of flexion), functional issues increase.  This includes difficulties with playing musical instruments, typing on the computer, sports, among others. Different patients are bothered at different levels of contracture.  We, as surgeons and doctors, try to define the point at which camptodactyly becomes a problem but the reality is that we can assign numbers like 30 degrees or 45 degrees or others but, again, it is really about the patient.

The good news about camptodactyly is that many patients will respond to therapy including stretching and splinting.  This depends, again, on the patient, but also on the degree of camptodactyly because once it is too severe, splinting and therapy become less effective.  Therapy and splinting may be a challenge in really young patients but is easier in adolescents (who really want their finger to get better).  Stretching during the day, specialized dynamic splints during the waking hours, and static splints at night all have a role.  Progress is typical.

Here is a recent patient with what I would consider mild camptodactyly.  He was excited to try therapy and I expect that he will improve.  I plan to post soon on the surgical options.

Bilateral small finger camptodactyly.  Note that the bottom hand, the right hand, is worse and was more of a problem.

Left small finger x-ray of camptodactyly.  Attempted full straightening.  The joint is well formed.

The more severely affected side in camptodactyly.  The joint is not quite normally formed but is generally satisfactory.

0 Comments

  1. There is some suggestion that more severe camptodactyly can lead to arthritis with age. However, it is unlikely that milder forms of the disease would do so. Sorry that I cannot be more definitive but the data is not great overall.

  2. My 18 yr old son has camptodactyl with more than 60-70% contractures to his last two fingers. Klienrt kutz hand
    Specialist and they had directed us to not do anything
    Until he had finished growing. Would it be in his best
    Intrest to look at a surgery for correction or have we
    Waited to long…☹

  3. Thank you for the question. My opinion is quite different. There is science that suggests that earlier surgery can influence bony development (shape). Nonetheless, surgery may still be helpful although x-rays will be an important part of the evaluation. Good luck.

  4. My daughter is 2 n half year old. She has trigger finger on her left hand pinkey finger which she got few days back. Recently she started bending other hand pinkey finger. We are worried if she developed trigger finger on both hands. Also her pinkey fingers are slightly bent towards ring fingers. Please advice us about the condition. Thanks in advance🙏

  5. Hello Sankar,

    Trigger finger and camptodactyly together would be highly uncommon. If she is loosing extension (straightening), it can give the impression of curvature to the ring. You need an evaluation by an experienced congenital hand surgeon. Splinting might be helpful.

    Good luck.

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