Stretching Alone Can Change P1 Bone Shape in Patients with Camptodactyly
Filed under Reviews
Woo Hong, S. Kim, J., Sang Kwon, O., Ho Lee, M., Sik Gong, H., Hyun Baek, G., (2019). Radiographic Remodeling of the Proximal Phalangeal Head Using a Stretching Exercise in Patients With Camptodactyly. J Hand Surg Am, 1.e1-1.e10
The Skinny – Camptodactyly is a congenital, nontraumatic flexion contracture of the PIP in fingers other than the thumb. Type 1 Camptodactyly ( Isolated anomaly in children <36 months) also includes volarly angulated and beak-shaped flat proximal phalangeal head. This study investigated the impact of a stretching-only camptodactyly treatment plan on restoration of Proximal Phalangeal head angulation as well as joint contracture.
In The Weeds – In a retrospective cohort study using radiographic series, 48 digits in 20 patients <36 months with >12 months of follow up were studies. 2 indexes were created to measure Head Angle (HA) and Head Triangle Ratio, or head shape (HTR).
Camptodactyly Stretches: Parents conducted a minimum of 20 sessions/day of a minimum of 5 minutes/session on affected fingers. Wrist and MCP were held in extension to increase FDS and FDP tension while force was applied to DIP joint flexion crease. This was done for 12 months.
Results: “roundness and concentricity of the proximal phalangeal head was restored in all cases” with statistical significance. Flexion contracture of the PIP decreased from 34 degrees ± 13 to 6 degrees ±7.
Bring it Home – Radiographic imaging indicates that stretching alone can restore the shape and angulation of the proximal phalangeal head and decrease flexion contracture. There was no correlation between contracture angle and boney shape throughout the study. This study had significant intra and inter-rater reliability for HA and HTR measures and control group illustrated that bone growth alone did not account for change in these parameters.
While other types (i.e. ages) of camptodactyly need to be studied, this study supports the strong value in stretching exercises for this diagnosis (camptodactyly exercises). Younger patients are particularly more receptive due to soft tissues being more extensile and the joint is more flexible. While the stretching protocol in this study is extensive, and may not be maintainable by many families, this approach is highly effective in achieving results non-surgically.
2 Comments
Leave a Comment
More To Read
Occupation Based Interventions in Hand Therapy
Keeping Occupation Based Interventions in Hand Therapy By: Tristany Hightower Are your treatments occupation based? Do you tailor your activity choices to fit the needs of each patient? As occupational therapists, we should be specialists in creating goals and interventions that are directed at returning our patients to meaningful occupations. Too often, hand therapy can…
A Review on the Conservative Management of Trigger Finger
Lunsford, D., Valdes, K., & Hengy, S. (2017). Conservative management of trigger finger: A systematic review. Journal of Hand Therapy, 32(2), 212-221. https://doi.org/10.1016/j.jht.2017.10.016 The Skinny The main purpose of the literature review was to determine the efficacy of conservative management of trigger finger (TF) through the use of an orthosis in addition to therapy. The review…
Top 5 Hand Therapy Toys for Kids
Many therapists in hand therapy clinics have a lot of tools for their adult patients, but may not have as many tools for the less common pediatric patient. With nearly 20 years experience in pediatrics, we’ve compiled a list of our top 5 picks for tools to use with pediatric patients in hand therapy. We…
What is the incidence of musculoskeletal complaints in the elbow, shoulder, and neck after hand and forearm injuries?
Winiarski, L. M., Livoni, J. D., Madsen, P. V., Rathleff, M. S., & Larsen, P. (2021). Concurrent musculoskeletal complaints in elbows, shoulders, and necks after common hand and forearm injuries or conditions: A cross-sectional study among 600 patients. Journal of hand therapy: official journal of the American Society of Hand Therapists, 34(4), 543–548. https://doi.org/10.1016/j.jht.2020.05.002 The Skinny: The…
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.
Is it possible for me to obtain a copy of the full article?
We can’t distribute the article itself, but the reference is provided so you can still find it. If you have a connection at a local university they may be able to pull it for you. Or Google Scholar will often have articles available in full print for viewing.