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
Title: Understanding De Quervain’s Pathology: A Comprehensive Exploration of Special Tests
Understanding De Quervain’s Pathology: A Comprehensive Exploration of Special Tests By: Miranda Materi De Quervain’s and Special Tests De Quervain’s tenosynovitis is a condition characterized by inflammation of the tendons on the thumb side of the wrist, causing pain and discomfort. These tendons include Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis as they pass through…
Read More
Dart-throwing Angle in Hand Therapy for Scapholunate (SL) Ligament Injuries.
Does Object Height Affect the Dart Throwing Motion Angle During Seated Activities of Daily Living? Cohen, Y., Portnoy, S., Levanon, Y., Friedman, J. (2020). Does object height affect the dart throwers motion angle during seated activities of daily living. Journal of Motor Behavior, (52) 4. Article Review By: Rita Steffes The Skinny: Dart Throwers Motion…
Read More
What is the Effectiveness of IASTM?
Citation Kim, J., Sung, D. J., Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: Mechanisms and practical application. Journal of Exercise Rehabilitation, 13(1). doi: https://doi.org/10.12965/jer.1732824.412 The skinny IASTM is a relatively simple technique that uses the surface of an instrument to minimize the amount of pressure or force needed…
Read More
Do you know the secret ingredient to recovering from an injury?
Do you know the secret ingredient to recovering from an injury? I will give you a hint it is 5 letters and begins with the letter S. SLEEP Have you ever asked yourself a question – does sleep help injuries heal? This is for you to share with your patients but also serve as a…
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.