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
Extensor Tendon Repair Protocol (zone 4-7): Immediate Controlled Active Motion (ICAM)
Howell, J.W., Merritt, W. H., & Robinson, S. J. (2005). Immediate Controlled Active Motion Following Zone 4–7 Extensor Tendon Repair. Journal of hand therapy: 18, 182-90. The Skinny- For years immobilization was the standard procedure following extensor tendon injuries in zones 4-7. As expected immobilization caused lengthy rehabilitation times, stiff joints, and tendon adhesions often…
Hand therapy intervention activities for Chemo-Induced Peripheral Neuropathy (CIPN)
Blog Post Written By: Rita Steffes Patients with CIPN may present with symptoms that include numbness, tingling, hypersensitivity to cold, loss of tactile or vibration sensitivity, decreased balance, and shooting burning pain in their hands These symptoms make it difficult for oncology patients to participate in all activities of daily living with dressing, meal preparation,…
Closed Pulley Injuries in Rock Climbers
Mechanism of injury Grades of pulley injury Treatment options for closed rupture Outcome measures Return to climbing Exercise considerations Resources Bollen S. R. (1990). Upper limb injuries in elite rock climbers. Journal of the Royal College of Surgeons of Edinburgh, 35(6 Suppl), S18–S20. Bosco, F., Giustra, F., Lusso, A., Faccenda, C., Artiaco, S., & Massè, A. (2022).…
Dog Bites to the Hand: What Every Hand Therapist Should Know
What to Expect with a Dog Bite to the Hand for Hand Therapists By: Kathryn Harada Prevalence and Severity:One reason people seek hand therapy is for rehabilitation after an animal bites. In the US alone, 1% of emergency department visits are due to animal bites each year, resulting in 2 to 5 million animal bites…
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.