Total collateral ligament excision for contractures of the proximal interphalangeal joint

The complete excision of scarred proximal interphalangeal collateral ligaments as the cornerstone of surgical treatment for proximal interphalangeal joint contractures was evaluated. Supplemental palmar plate distal release, extensor tenolysis, and flexor sheath release were performed as needed. Sixteen patients with primary proximal interphalangeal joint contractures treated by this method were reviewed with the use of preoperative data obtained from chart review and postoperative data from direct patient examination. The average range of motion increased from 38 degrees to 78 degrees. No patients had instability of the proximal interphalangeal joints on manual testing and x-ray examination. This radical surgical approach to contracted proximal interphalangeal joints is justified by the improved range of motion without instability.