Interphalangeal joint stiffness following claw hand reconstruction

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Claw hand reconstruction often requires extensive post-operative physiotherapy.
• Conventional immobilization leads to prolonged rehabilitation, including tendon re-education and management of interphalangeal joint stiffness.

Purpose of the Study:

• To evaluate a modified immobilization technique for claw hand correction.
• To assess the impact of different immobilization methods on post-operative interphalangeal joint stiffness and physiotherapy requirements.

Main Methods:

• Fifty hands without pre-operative interphalangeal joint stiffness underwent claw hand correction.
• Three immobilization techniques were compared: conventional (20 hands), modification type 1 (10 hands), and modification type 2 (20 hands).
• Modification type 2 involved a volar plaster slab from below the elbow to fingertips with circumferential plaster to the metacarpophalangeal joints.

Main Results:

• Modification type 1 yielded unsatisfactory results.
• Modification type 2 demonstrated a near-complete absence of interphalangeal joint stiffness.
• No additional physiotherapy was needed to address minimal stiffness with modification type 2, preserving surgical outcomes.

Conclusions:

• Modified immobilization type 2 is highly effective in preventing post-operative interphalangeal joint stiffness after claw hand surgery.
• This technique reduces the need for extensive physiotherapy, streamlining patient recovery.
• Modification type 2 is recommended for clinical practice in claw hand reconstruction.