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Management of posttraumatic proximal interphalangeal joint contracture.
Shirzad Houshian1, Shan Shan Jing, Chandrasekar Chikkamuniyappa
1Department of Orthopaedic Surgery, Braintree Community Hospital, Mid Essex, UK. sh_houshian@yahoo.dk
The Journal of Hand Surgery
|July 30, 2013
Summary
Proximal interphalangeal (PIP) joint flexion contractures are challenging. Nonoperative treatments and external fixation show promise, guiding surgical decisions for better outcomes.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Rehabilitative Medicine
Background:
- Chronic flexion contracture of the proximal interphalangeal (PIP) joint is a frequent and difficult issue for hand surgeons.
- Existing treatment modalities have yielded limited success over time.
Purpose of the Study:
- To provide an updated review on the current management strategies for PIP joint contractures.
- To present a treatment decision-making flowchart for PIP joint contractures.
Main Methods:
- Literature review of current management options for PIP joint contractures.
- Analysis of nonoperative treatments (serial casting, splinting) and surgical interventions (open release, external fixation).
Main Results:
- Nonoperative management should be attempted prior to surgical intervention.
- Open surgical release is indicated for selected patients.
- External fixation presents a potentially useful alternative treatment with encouraging results.
Conclusions:
- A structured approach to PIP joint contracture management is essential.
- External fixation offers a viable alternative for specific cases.
- The review aims to assist surgeons in making informed treatment decisions.
