Management of posttraumatic finger contractures in adults

Hand Surg Rehabil. 2018 Oct;37(5):275-280. doi: 10.1016/j.hansur.2018.06.003. Epub 2018 Jul 20.

Abstract

This lecture will focus on posttraumatic finger contractures affecting the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in adults. The pathophysiology, main causes and essential rehabilitation methods that can be used before resorting to surgical treatment are described, along with the clinical examination. The goal is to define the surgical indications, even though the literature shows the functional outcomes are disappointing. While there is little to no change in a joint's angular amplitude, the functional range of motion can be improved. There is practically no functional improvement except in cases of MCP extension contracture. For the PIP joint, the aim is to shift the range of motion into the functional range. Surgical approaches, surgical techniques and rehabilitation protocols are described in detail.

Keywords: Arthrolyse; Arthrolysis; Contracture; Doigt; Finger; Interphalangienne proximale; Metacarpophalangeal; Métacarpophalangienne; Proximal interphalangeal; Raideurs; Stiffness; Tenoarthrolysis.; Ténolyse.

Publication types

  • Review

MeSH terms

  • Contracture / physiopathology
  • Contracture / therapy*
  • External Fixators
  • Finger Injuries / physiopathology
  • Finger Joint / anatomy & histology
  • Finger Joint / physiopathology*
  • Finger Joint / surgery
  • Humans
  • Metacarpophalangeal Joint / anatomy & histology
  • Metacarpophalangeal Joint / physiopathology*
  • Metacarpophalangeal Joint / surgery
  • Occupational Therapy
  • Physical Therapy Modalities
  • Range of Motion, Articular / physiology
  • Splints