title: Severe camptodactyly: A systematic surgeon and therapist collaboration.
abstract: BACKGROUND
  Although common, the treatment of camptodactyly is controversial.
  
  
  OBJECTIVE
  Our purpose is to delineate a logical stepwise treatment plan based on corresponding components of the pre-operative and intraoperative evaluation of camptodactyly. In addition, describe structure rehabilitation plan utilizing the same stepwise evaluation.
  
  
  METHODS
  With the use of a retrospective cohort study design, we reviewed 18 consecutively operated digits in twelve patients with camptodactyly affecting the proximal interphalangeal (PIP) joint. There were five girls and eight boys, averaging eight years of age (range: 9 months to 15 years) at surgery.
  
  
  RESULTS
  Surgery corrected flexion contractures with mean post-operative flexion contracture of 3° (range 0-25°) at mean follow-up of 11 months (range 3-32 months). 15 of 18 digits achieved full active PIP extension.
  
  
  CONCLUSIONS
  By employing a detailed clinical assessment to guide surgical treatment followed by focused therapy, we have markedly improved flexion contractures in digits with moderate to severe camptodactyly.
  
  
  CONCLUSIONS
  Hand therapy is essential to maintain and further surgical improvement of passive extension and to regain active extension following surgery.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopedic Surgery, Division of Plastic Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Netscher
authors.affiliation: Department of Physical Medicine and Rehabilitation, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, RCL 117, Houston, TX 77030, USA. Electronic address: kimberly.goldiestaines@va.gov.
authors.forename: Kimberly Goldie
authors.initials: KG
authors.lastname: Staines
authors.affiliation: Department of Orthopedic Surgery, Division of Plastic Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: Kristy L
authors.initials: KL
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D005384:Finger Joint; D006226:Hand Deformities / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D007223:Infant; D008297:Male; D009989:Orthotic Devices; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Camptodactyly; Flexor contraction resolution; Intrinsic rehabilitation; Operative planning; Relative motion; Stepwise surgery; Technique