A Two-Point Flexion Orthosis for Proximal Interphalangeal Joint Stiffness: Simplified Traction Without Volar...

Area of Science:

• Orthopedic surgery
• Hand rehabilitation
• Biomechanical engineering

Background:

• Proximal interphalangeal (PIP) joint stiffness is a common challenge in hand rehabilitation.
• Delayed treatment of PIP joint trauma can lead to capsular contracture and functional loss.
• Traditional 3-point pressure orthoses have limitations, including volar component impingement during flexion improvement.

Purpose of the Study:

• To describe a novel 2-point static progressive orthosis designed to restore PIP joint flexion.
• To present an orthotic solution that avoids volar obstruction and minimizes shear forces.
• To offer a practical alternative for managing PIP joint flexion deficits.

Main Methods:

• Development of a novel 2-point static progressive orthosis with a dorsal thermoplastic base and a semi-rigid dorsal ring.
• Application of adjustable flexion traction via a dorsal thread, bypassing the palmar side of the joint.
• Fabrication using low-cost materials, achievable in under 20 minutes.

Main Results:

• The novel orthosis facilitates PIP joint flexion without volar interference, enhancing patient comfort.
• Clinical use indicates improved range of motion and patient tolerance compared to conventional methods.
• The device simplifies orthotic design, fabrication, and monitoring for therapists.

Conclusions:

• This 2-point static progressive orthosis offers a practical and accessible alternative for managing post-traumatic or postsurgical PIP joint flexion contractures.
• The design overcomes limitations of traditional orthoses, particularly volar impingement.
• It is indicated for patients with passive range of motion exceeding 60 degrees, excluding extension contractures or night use.