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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Hand Therapy Management of Camptodactyly

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  • presenting/speaker Orla Daly - Paediatric Occupational Therapy, Royal London Hospital, London, United Kingdom
  • Amanda Barnes - Paediatric Occupational Therapy, Royal London Hospital, London, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1136

doi: 10.3205/19ifssh1471, urn:nbn:de:0183-19ifssh14710

Published: February 6, 2020

© 2020 Daly et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Clinical issue/s: Camptodactyly is a congenital flexion deformity of the middle joint (PIPJ) of a finger, which may progress if left untreated.

A review of the literature found that there is much debate concerning the treatment of camptodactyly. A large proportion of the literature centres on surgical management and although some reports have been issued on conservative treatment, the results of a consistent treatment modality used with sufficient follow-up are not known. There are no published clinical practice guidelines for the conservative management of camptodactyly in children and adolescents.

Clinical reasoning: Aims

  • To evaluate the effectiveness of previous treatment provided to children and adolescents with camptodactyly in terms of active and passive PIPJ extension at a European children's hospital.
  • To extrapolate the factors affecting improvement in active and passive PIPJ extension.

Innovative, analytical or new approach: This service evaluation project was based on a retrospective observational model, using data already documented in patient records for clinical purposes. Data was collected where either active or passive initial and last PIPJ extension was available. Results were analysed using statistical tests for non-parametric data to determine significance.

Contribution to advancing HT practice: 25 patients (16 female, 9 male) with a diagnosis of camptodactyly were initally evaluated totalling 55 digits.

The mean improvement in active PIPJ extension was 12.9 degrees ranging from 17 degrees worse - 61 degrees improvement (p<0.0003) and passive PIPJ extension was 10.4 degrees ranging from 18 degrees worse - 60 degrees improvement (p<0.0005).

A moderately weak correlation towards improved range with a shorter preceding history for passive PIPJ was found (p<0.003).

Those who adhered to therapy more than 90% had significantly improved mean passive PIPJ extension compared those who adhered less than 50% or 50-90%(p=0.00005).

These results and more will be used to educate primary care teams, parents, surgeons and hand therapists re: camptodactyly management.