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
Flexor tendon rehabilitation in the 21st century: A systematic review
Neiduski, R. L. & Powell, R. K. (2019). Flexor tendon rehabilitation in the 21st century: A systematic review. Journal of Hand Therapy, 32, 165-174. The Skinny The objective of the study was to determine if there was evidence to support 1 type of exercise regimen. Exercise regimens reviewed include place and holds, early passive or…
Read More
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…
Read More
Increase Shoulder Range by Improving Scapulohumeral Rhythm
Scapulohumeral rhythm is often the key component when treating shoulder conditions and the lack of total shoulder range of motion. This may also be a critical component to prevent shoulder conditions during the rehabilitation of other upper extremity conditions such as distal radius fractures, tendon injuries, and elbow injuries. Scapulohumeral rhythm is the rhythm in…
Read More
Do you know the difference between an Electromyography (EMG) and a Nerve Conduction Velocity (NCV) Study?
Do you know the difference between EMG and NCV (an Electromyography and a Nerve Conduction Velocity Study? The term nerve test is usually a broad term that typically indicates both an Electromyography (EMG) and a Nerve Conduction Velocity (NCV) study (EMG vs NCV). An EMG looks at the electrical signals your muscle makes when at…
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.