Soft-Tissue Surgery for Camptodactyly Corrects Skeletal Changes.
BACKGROUND
This study demonstrates the potential for radiographic and clinical improvement with surgical correction of camptodactyly. Although historically these radiographic changes have been held to be permanent, the authors encourage surgical intervention for digits with severe flexion contracture or progressive radiographic changes before skeletal maturity is reached.


METHODS
The authors assessed 18 consecutively operated fingers in nine skeletally immature patients in whom advanced radiographic articular changes had occurred. Mean preoperative flexion contracture was 63 degrees (range, 35 to 105 degrees). The average age of the patients was 11 years (range, 4 to 15 years) at the time of surgery. Clinical response to surgery was studied, but radiographic articular changes were followed postoperatively as a primary outcome.


RESULTS
Each patient demonstrated the classic preoperative radiographic joint changes on radiographic films at the affected proximal interphalangeal or distal interphalangeal joint. All patients had substantial clinical improvement postoperatively. Two digits had extensive radiographic damage, requiring proximal interphalangeal joint arthrodesis. Fifteen of the remaining 16 digits (94 percent) had substantial improvement or full restoration of radiographic articular congruency at average follow-up of 9 months (range, 3 to 18 months). The only joint that did not remodel fully was the one that did not have complete clinical correction.


CONCLUSIONS
Even in patients with severe radiographic changes from camptodactyly, surgery can effectively improve range of motion. Once radiographic articular changes become apparent, surgical correction should be undertaken not only to prevent further joint damage but also to reverse these radiographic changes before skeletal maturity is reached.


METHODS
Therapeutic, IV.
Houston, Texas From the Department of Orthopedic Surgery and the Division of Plastic Surgery, Baylor College of Medicine.
David T
DT
Netscher
Kristy L
KL
Hamilton
Lior
L
Paz
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005384:Finger Joint / Q000002:abnormalities / Q000601:surgery; D005500:Follow-Up Studies; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000534:rehabilitation; D020127:Recovery of Function; D012189:Retrospective Studies; D064746:Therapy, Soft Tissue / Q000379:methods