gms | German Medical Science

Objectives/Interrogation: Camptodactyly is a congenital deformity that appears as a contracture in flexion of the proximal interphalangeal (PIP) joint. Mostly involves the lesser fingers, mono or bilateral. There isn't any consensus about the pathogenesis but the litterature reports specific modifications in the soft tissues that bring to an impairment of flexion and extention strenght acting on PIP joint. These imbalances cause also a deformity of the bony shape of the PIP. The contracture worsts during the growth sprout periods. Surgical treatment is for patients with a contracture over 40° who conservative treatment failed.

In this presentation will be described the pathologic steps, the author's preferred surgical procedure and long term results.

Methods: From 2010 to 2018, 45 patients have been surgically treated; 56% male and 44% female, for 52 fingers at all. The mostly involved fingers are the ulnar (84%), 27% bilateral. Almost The 70% of the patients started with a contracture over 60°. Every patient has been studied with a preoperative AP an LL Xray and a clinical examination of the degree of contracture and PROM. Only the patient with a mild or moderate bone degeneration have been included. All the patients have been approached through a Malek surgical technique, consisting in a volar incision on the PIP, the detachement of FSD distal insertion, the release of the volar plate, skin graft from the volar wrist crease and arthrorisis in extention for 4 weeks, after surgery the same splinting and rehabilitation protocol. We have recently checked 45 patients with a AP and LL Xray view and a clinical evalutation of the residual contracture and the PROM using the Siegert scale, with an average follow up of 52 months (97-6).

Results and Conclusions: About postoperative results 60.7% are Exellent (complete extention, < 15° loss of flexion), 28.5% are Good (gain of extention >40°, loss of flexion < 20°), 11.8% are Fairy (gain of extention >20°, loss of flexion <45°), No case of a Poor result have been detected. No progression of the bone deformity at the postoperative Xray check has been observed.

Camptodactyly is a common (1% of population) congenital pathology. Surgical tratement is considered for patients for whom the conservative treatment failed or fir those with a real severe contracture. About our casistic almost 90% of the patient have a Exellent or Good result after surgery (sec. Siegert). The radiological pattern of the PIP bones shows no progression of the deformity from the preoperative stage.