Clinical and psychosocial characteristics of persistent finger post-traumatic segmentary exclusion syndrome: A...

Segmentary exclusion syndrome is a motor behavior disorder characterized by non-use or underuse of a limb segment, typically following local inflammation after trauma. Despite its significant impact on hand function and quality of life, segmentary exclusion syndrome is underrecognized and often diagnosed late. This study describes the population, and the symptoms associated with persistent finger segmentary exclusion syndrome.

A retrospective analysis was conducted in a specialized hand surgery center. Twenty-one adult patients diagnosed with segmentary exclusion syndrome persisting >3 mo post-trauma were included. Data collected included demographics, injury mechanisms, somatosensory disorders, flexion active range of motion, pain during movement, psychosocial flags, and sleep disturbances.

Somatosensory disorders were present in 81% of patients, with allodynia (76%) and hyperesthesia (18%) as the most common subtypes. Flexion active range of motion limitations were observed in 52% of patients, often co-occurring with sensory disturbances or pain. Pain was reported in 29% of patients but was rarely an isolated symptom. Psychosocial factors were prevalent, with yellow flags in 71%, black flags in 62%, and blue flags in 29%. Sleep disturbances were reported in 52% of cases.

Persistent finger segmentary exclusion syndrome is primarily associated with somatosensory disturbances, particularly allodynia and hyperesthesia, which appear central to its chronicization. Psychosocial factors and sleep disturbances were highly prevalent. Early recognition and a holistic, multidisciplinary approach seem therefore essential to improve outcomes in affected patients.

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