Nonoperative Treatment of Fixed Flexion Deformity of the Proximal Interphalangeal Joint

1999 ◽  
Vol 24 (3) ◽  
pp. 281-283 ◽  
Author(s):  
E. HUNTER ◽  
J. LAVERTY ◽  
R. POLLOCK ◽  
R. BIRCH
Keyword(s):  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexion Deformity ◽  
Range Of Movement ◽  
The Average Range ◽  
Fixed Flexion Deformity

Sixty-one stiff, stable proximal interphalangeal joints were treated by exercise and splinting. The average range of movement was 24° to 67° before treatment; this increased to 8° to 98° after treatment. The indications and technique are described.

Hammer Toe Correction Using an Absorbable Intramedullary Pin

2007 ◽  
Vol 28 (8) ◽  
pp. 916-920 ◽  
Author(s):  
Kurt F. Konkel ◽  
Andrea G. Menger ◽  
Sharon Ann Retzlaff
Keyword(s):  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Foot Deformities ◽  
Flexion Deformity ◽  
Hammer Toe ◽  
Intramedullary Canal ◽  
Pin Track ◽  
Fixed Flexion Deformity

Background: Fixed flexion deformity of the proximal interphalangeal joint with or without hyperextension of the metatarsophalangeal joint is one of the most common foot deformities. Many operative options have been recommended. Complaints after operative procedures include a too straight toe, floating toe, painful toe recurvatum, mallet toe, pin track infection, broken hardware, and the necessity of removing hardware. A proximal interphalangeal joint arthrodesis for hammertoe deformity using a 2-mm absorbable pin for internal fixation is described. Methods: The results of 48 toe arthrodeses in 35 patients were reviewed. Followup ranged from 16 to 58 (average 38.5) months. Results: The procedure is simple and safe for the correction of painful rigid hammertoe deformities. Patient satisfaction was high, complications were minimal, and followup required no pin management or removal. Conclusions: This procedure can be used for hammer toe deformities requiring surgery when the metatarsophalangeal joint is stable, the skin is not compromised, and the intramedullary canal of the proximal phalanx is 2.0 mm or less. It also has been useful in stabilizing hammertoe correction when there are severe pre-existing metal allergies.

Contracture of the Proximal Interphalangeal Joint in Dupuytren’s Disease

1991 ◽  
Vol 16 (4) ◽  
pp. 446-448 ◽  
Author(s):  
J. G. ANDREW
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Corrective Surgery ◽  
Collateral Ligaments ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Secondary Damage ◽  
Fixed Flexion Deformity

The correction of fixed flexion deformity at the P.I.P. joint in Dupuytren’s disease is often difficult. This paper reports an anatomical study of this joint in fingers amputated because of this condition. All the joints would extend fully after release of the accessory collateral ligaments and volar plate. Lateral and dorsal structures showed severe secondary damage and it is suggested that these changes may explain the poor results of corrective surgery to this joint in Dupuytren’s disease.

Trigger Finger Treatment by Ulnar Superficialis Slip Resection (U.S.S.R.)

2004 ◽  
Vol 29 (4) ◽  
pp. 368-373 ◽  
Author(s):  
D. LE VIET ◽  
I. TSIONOS ◽  
M. BOULOUEDNINE ◽  
D. HANNOUCHE
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Flexion Deformity ◽  
Full Extension ◽  
History Of ◽  
Flexor Digitorum ◽  
Fixed Flexion Deformity ◽  
A1 Pulley

Surgical release of the A1 pulley for treatment of trigger finger normally produces excellent results. However, in patients with long-standing disease, there may be a persistent fixed flexion deformity of the proximal interphalangeal joint. This is sometimes due to a degenerative thickening of the flexor tendons and may be treated by resection of the ulnar slip of flexor digitorum superficialis tendon. One hundred seventy-two patients (228 fingers) who had undergone this procedure were reviewed at a mean follow-up of 66 months. Mean pre-operative fixed flexion deformity of the proximal interphalangeal joint was 33°. All but eight fingers were improved by surgery and there was an average gain of 26° in passive extension (7° residual fixed flexion deformity) of the proximal interphalangeal joint. Full extension was attained in 141 of the 228 fingers, and in all 101 fingers with a pre-operative loss of passive extension of 30° or less. This technique is indicated for patients with loss of passive extension in the proximal interphalangeal joint and a long history of triggering.

scholarly journals Orthotic management of fixed flexion deformity of the proximal interphalangeal joint following traumatic injury: A systematic review

2018 ◽  
Vol 31 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Nicole Young ◽  
Nichola Terrington ◽  
Diana Francis ◽  
Luke S Robinson
Keyword(s):  
Meta Analysis ◽  
Hand Function ◽  
Traumatic Injury ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Occupational Performance ◽  
Flexion Deformity ◽  
Joint Injury ◽  
Exercise Programmes ◽  
Fixed Flexion Deformity

Background/objective Fixed flexion deformity of the proximal interphalangeal joint can commonly occur following a traumatic injury impacting on hand function and occupational performance. Numerous interventions have been proposed for fixed flexion deformity resolution. This paper investigates the efficacy of static or dynamic orthoses in reducing fixed flexion deformity contracture following traumatic proximal interphalangeal joint injury. Methods A multi-database search of three databases (CINAHL, EMBASE, MEDLINE) was conducted. Data extracted for each study were design, patient descriptions, degree of fixed flexion deformity pre- and post-orthoses, and prescribed interventions and exercise programmes. Results The search yielded 643 studies, of which eight met the inclusion criteria. Studies used heterogeneous methodologies investigating various orthotic interventions. Meta-analysis or pooling of results was not possible. Dissimilar orthotic wear regimes were noted in all studies and an alternative clinical significance outcome was found. Conclusion More research is required to support clinical reasoning in orthotic choice for fixed flexion deformity of the proximal interphalangeal joint post-traumatic injury.

Dynamic External Fixation for Pilon Fractures of the Interphalangeal Joints

2001 ◽  
Vol 26 (2) ◽  
pp. 122-124 ◽  
Author(s):  
M. C. HYNES ◽  
G. E. B. GIDDINS
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Simple Solution ◽  
Range Of Movement ◽  
The Average Range ◽  
Pilon Fractures

Eight consecutive pilon fractures of the finger proximal interphalangeal joint and one of the interphalangeal joint of the thumb were treated by closed reduction and application of a new dynamic external fixator. The average range of movement achieved was 12°–88° and there were no serious complications. The technique described offers an effective and simple solution for treatment of pilon fractures of the interphalangeal joint.

Proximal Interphalangeal Joint Release in Dupuytren’s Disease of the Little Finger

2004 ◽  
Vol 29 (1) ◽  
pp. 15-17 ◽  
Author(s):  
J. F. S. RITCHIE ◽  
K. M. VENU ◽  
K. PILLAI ◽  
D. H. YANNI
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Sequential Release ◽  
Full Correction ◽  
A Prospective Study ◽  
Fixed Flexion Deformity ◽  
Little Finger

We present a prospective study, with 3-year follow-up, of the role and outcome of fasciectomy plus sequential surgical release of structures of the proximal interphalangeal joint in Dupuytren’s contracture of the little finger. Our treatment programme involves fasciectomy for all patients followed by sequential release of the accessory collateral ligament and volar plate as necessary. Of the 19 fingers in the study, eight achieved a full correction by fasciectomy alone, and in these cases there was a fixed flexion deformity of 6° at 3 months and 8° at 3 years. The remaining 11 fingers (initial mean deformity 70° flexion) were left with a fixed flexion deformity of 42° after fasciectomy which reduced to 7° with capsuloligamentous release. This increased to 26° at 3 months but then remained relatively stable, increasing only to 29° at 3 years. In our experience sequential proximal interphalangeal joint release has led to consistently good results with few complications in the correction of severe Dupuytren’s disease of the little finger.

Results of Vascularized Joint Transfers from the Foot

1997 ◽  
Vol 22 (4) ◽  
pp. 492-498 ◽  
Author(s):  
G. DAUTEL ◽  
M. MERLE
Keyword(s):  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Indications For Surgery ◽  
Pip Joint ◽  
Prosthetic Implant ◽  
Metatarsophalangeal Joints ◽  
Second Toe ◽  
The Average Range

We report our results in ten cases of vascularized joint transfer to reconstruct the proximal interphalangeal joint (five cases) or metacarpophalangeal joints (five cases). Donor sites were the proximal interphalangeal or the metatarsophalangeal joints of the second toe. Indications for surgery were the need to reconstruct both the growth plate and joint space in children or the impossibility of a conventional prosthetic implant. The average range of motion was 44° for the PIP joint and 53° for the MP joint at a mean follow-up of 22.7 months.

Fractures of the Phalanges: Results of Internal Fixation Using 1.5mm and 2mm A. O. Screws

1987 ◽  
Vol 12 (1) ◽  
pp. 28-33
Author(s):  
D. J. FORD ◽  
S. EL-HADIDI ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Internal Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Active Movement ◽  
Flexion Deformity ◽  
The Mean ◽  
Condylar Fractures ◽  
Phalangeal Fractures ◽  
Mean Time

Thirty-six patients were treated for 38 phalangeal fractures using 1.5 mm and 2 mm A. O. screws. Plates were not used in the fingers. Oblique fractures of the condyles, shafts or bases of the proximal or middle phalanges were treated by internal fixation because of instability, displacement or rotation. 40% of fractures had associated skin wounds, were comminuted or had damage to the extensor mechanism. The mean duration of post-operative immobilization was 9 days and the mean time off work was 6 weeks. Total active movement in the involved ray was 220 degrees or greater in 24 cases, 180 degrees to 215 degrees in eight cases, and less than 180 degrees in two patients at follow up. The patients were reviewed between three and 54 months after treatment and the mean duration of follow up was 24 months. The most frequent complication was 10 degrees to 30 degrees of flexion deformity of the proximal interphalangeal joint after internal fixation of condylar fractures. Results were satisfactory in 90% of cases.

Nonoperative treatment of PIPJ flexion contractures associated with Dupuytren’s disease

2011 ◽  
Vol 37 (8) ◽  
pp. 722-727 ◽  
Author(s):  
J. Larocerie-Salgado ◽  
J. Davidson
Keyword(s):  
Soft Tissue ◽  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Patient Dissatisfaction ◽  
Flexion Contractures ◽  
Alternative Treatment Option ◽  
Soft Tissue Mobilization

Post-surgical outcomes in patients with Dupuytren’s disease causing flexion contractures of the proximal interphalangeal joint can be inconsistent and are often associated with protracted rehabilitation, reduced flexion, recurrence of the contracture, and patient dissatisfaction. An alternative treatment option, comprised of splinting and soft tissue mobilization techniques, was introduced to stabilize early contractures of the proximal interphalangeal joint in the hopes of delaying or obviating surgery. Over the course of approximately 12.6 months (±7.8), thirteen patients were followed at the hand clinic at Hotel Dieu Hospital in Kingston. One patient was unable to complete the course of therapy. Of the remaining patients, analysis showed significant improvement in active proximal interphalangeal joint extension of approximately 14.6° (SD: ±5.1°; range: 5–25°) over the course of the treatment ( p < .05). Nighttime static extension splinting and soft tissue mobilization techniques appear to delay and possibly prevent the need for surgery in individuals with flexion contractures of the proximal interphalangeal joint due to Dupuytren’s disease.

X-ray Guided Steroid Injections for Proximal Interphalangeal Joint Osteoarthritis of the Fingers

2017 ◽  
Vol 22 (02) ◽  
pp. 214-218 ◽  
Author(s):  
Clare A. Miller ◽  
Stephen Dalgleish ◽  
Quentin Cox
Keyword(s):  
Simple Procedure ◽  
Hand Function ◽  
Image Intensifier ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Prospective Audit ◽  
Range Of Movement ◽  
Steroid Injections ◽  
X Ray ◽  
Pain Scores

Background: Osteoarthritis of the finger proximal interphalangeal joints (PIPJ's) is common and severely limits hand function. Intra-articular steroid injections are frequently used, but there is little research assessing this treatment option. Methods: This was a prospective audit of patients undergoing intra-articular steroid injections into the PIPJ under image intensifier guidance. The aims were to assess the duration of pain relief, hand function and range of movement following this procedure. Fifty injected joints were followed up at six weeks, three and six months. Results: There were significant improvements in both pain scores and the range of movement for up to three months. Analgesia requirements decreased and hand function improved up to three months. By six months, patients were approaching their preinjection scores. Conclusions: X-ray guided injections are a simple procedure which can be effectively performed in the out- patient setting, resulting in satisfied patients with improved hand function and pain scores.

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