title: Soft tissue distraction using pentagonal frame for long-standing traumatic flexion deformity of interphalangeal joints.
abstract: OBJECTIVE
  Interphalangeal joint contracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture release and partial ligament transection and volar plate removal.
  
  
  METHODS
  In this prospective study, a total of 40 patients in two equal groups (A and B) were studied. Patients suffering from chronic flexion contracture of abrasive traumatic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting.
  
  
  RESULTS
  Analyzed data revealed a significant difference between the two groups for range of motion in the proximal interphalangeal joints (P less than 0.05), while it was not meaningful in the distal interphalangeal joints (P larger than 0.05). There was not a significant difference in the degrees of flexion contracture between groups (P larger than 0.05). Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proximal interphalangeal joints (P less than 0.001), while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention (P less than 0.001).
  
  
  CONCLUSIONS
  Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral ligament and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of motion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints.
authors.affiliation: Firoozgar Clinical Research Development Center, Tehran University of Medical Sciences, Tehran 1951955531, Iran.
authors.forename: Shaharm
authors.initials: S
authors.lastname: Nazerani
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Keramati
authors.forename: Jalal
authors.initials: J
authors.lastname: Vahedian
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Fereshtehnejad
mesh_terms: D003286:Contracture; D005384:Finger Joint; D006801:Humans; D004204:Joint Dislocations; D011446:Prospective Studies; D016059:Range of Motion, Articular