Long-term results of surgical management of proximal interphalangeal joint contracture

To evaluate the long-term results of surgical treatment of proximal interphalangeal (PIP) joint contractures, 68 PIP joints were retrospectively reviewed with a minimum follow-up period of 24 months. Preoperative and intraoperative factors were studied for outcomes and subjected to statistical analysis. Among the total group the average improvement was 7.5 degrees. When grouped by diagnosis into simple (less severe diagnoses) and complex (more severe diagnoses) the average degrees gained were 17.2 degrees and 0.5 degrees, respectively. The statistically significant factors that were identified that affected results were age, number of prior procedures, preoperative flexion, removal of an exostosis, number of structures addressed, and preoperative arc of motion. The second surgery (joints requiring repeat release or salvage procedure) rates were 35% overall, 29% simple, and 39% complex; the difference was not significant. The best surgical candidate is a patient younger than 28 years with a less severe diagnosis and who has preoperative maximum flexion measurement < 43 degrees.