gms | German Medical Science

Objectives/Interrogation: The aims of this study were to verify the recovery of proximal phalangeal head after stretching exercise in patients with infantile type camptodactyly and to propose radiographic indices to quantify bony deformities.

Methods: Forty-eight fingers of 20 patients (9 males/11 females, mean age 14.2 ± 12.16 months, age range 1-35 months) with camptodactyly were selected and normal 163 fingers in 66 participants also included to estimate reference values of proposed indices. Patients with camptodactyly were younger than 36-month-old and had no other combined anomalies of the hand. The stretching exercise were instructed to all patients and their parents. The new radiographic parameters, head triangle ratio (HTR) and head angle (HA) were estimated on finger lateral radiographs taken at the initial visit and at the point of 12-month follow up. The extent of proximal interphalangeal joint (PIPJ) flexion contracture was evaluated to determine clinical outcomes from conserative treatment. The normal group comprised patients who visited our clinic with unilateral hand trauma to verify the reference values of HTA and HA accordance with finger types and age ranges.

Results and Conclusions: Two suggested radiographic parameters showed significant differences before and after intervention. The extent of PIPJ flexion contracture showed significant improvement. The HTA and HA had excellent validity and reliability. In the normal group, both parameters did not show significant differences accordance with finger types and age ranges. The stretching exercise could not only improve the motion of the proximal phalangeal joint but also have influence on recovery of congruency of proximal phalangeal head in patients with infantile type camptodactyly. The HTR and HA would be useful indices for objectifying the degree of bony deformities in patients with camptodactyly.