title: Correction of long term joint contractures of the hand by distraction. A case report.
abstract: Joint contractures are a common complication of hand trauma. The conventional treatment consists of arthrolysis, tenolysis and occasionally arthrodesis. Frequently, this does not achieve a good result, particularly when there has been a long delay in presentation. Progressive lengthening of a joint by distraction (joint distraction) allows the release of joint contractures even in cases of failure of traditional methods. We present a case of a delayed (20 years) work related traumatic flexion deformity of the PIP joint of the left index and middle fingers. This was the result of a complete division of both flexor tendons of both fingers. The range of movements, both active and passive, was limited to 90/100 degrees in the index finger and 95/100 degrees in the middle finger. Following joint distraction using our lengthening device (Antãotrade mark, Portugal) the patient was able to achieve an active and passive range of movements of 10/100 degrees for the PIP joint of the index finger and 40/100 degrees of the middle. This clinical case shows the simplicity and application of our technique for the correction of joint contractures.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Oporto Medical School, São João Hospital, Oporto, Portugal. pedrosilva@portugalmail.pt
authors.forename: P Natividade
authors.initials: PN
authors.lastname: da Silva
authors.forename: R
authors.initials: R
authors.lastname: Barbosa
authors.forename: P
authors.initials: P
authors.lastname: Ferreira
authors.forename: A
authors.initials: A
authors.lastname: Ferreira
authors.forename: E
authors.initials: E
authors.lastname: Malheiro
authors.forename: A
authors.initials: A
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Reis
authors.forename: J
authors.initials: J
authors.lastname: Amarante
mesh_terms: D000328:Adult; D003286:Contracture / Q000503:physiopathology / Q000601:surgery*; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery*; D006227:Hand Deformities, Acquired / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000503:physiopathology / Q000601:surgery; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome