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
K-tape and Cerebral Palsy
Allah-Rastii, Z., Shamsoddini, A., Dalvand, H. and Labaf, S. (2017). The effect of kinesio taping on handgrip and active range of motion of hand in children with cerebral palsy. Iranian Journal of Child Neurology, 11(4), 43-51. The Skinny: Cerebral palsy is a non-progressive motor impairment caused by injury to the developing brain that can…
Read More
Management of the Stiff Finger: Evidence and Outcomes
Title: Management of the Stiff Finger: Evidence and Outcomes Reference: Yang, G., McGlinn, E. P., & Chung, K. C. (2014). Management of the stiff finger: Evidence and outcomes. Clinics in Plastic Surgery, 41(3), 501–512. https://doi.org/10.1016/j.cps.2014.03.011 Article Review By: Tommi Hintnaus The Skinny: This study focuses on understanding and managing finger stiffness, a condition characterized by…
Read More
Carpal Tunnel Syndrome: How does traditional hand therapy compare with neurodynamic therapy?
Hamzeh, H., Mohammad, M., Alghwiri, A., & Hawamdeh, Z. (2021). The long-term effect of neurodynamics vs. exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial. Journal of Hand Therapy, 34, 521-530. The Skinny: Carpal tunnel is the most common peripheral nerve compression problem. There is now some…
Read More
Orthotic Options for Hand Burns
By: Sophia Grimm Hand burns can be very challenging to treat, and successful rehabilitation begins early after acute injury. Following a burn injury, scar contractures are the primary reason for the deformity of the hand. Therefore, proper orthotic intervention is key to preventing joint and ligament contractures (Kelly, Berenz & Williams, 2019). Splinting goals following…
Read More
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.