- Discussion:
- camptodactyly involves a PIP flexion deformity which usually involves the little finger;
- deformity is likely due to imbalance caused by extensor hood insufficiency, a tight FDS,
and/or abnormal intrinsic insertion volarward;
- cases which involve contracture of the FDS, may show a dynamic deformity which decreases as the
wrist is flexed (w/ time, chronic adaptive changes occur and static contracture occurs);
- Radiographs:
- look for small metacarpal head articulating w/ dorsal surface of middle phalanx;
- Non Operative Treatment:
- be results achieved w/ early treatment;
- passive stretching or static splinting may correct the deformity;
- surgery is not indicated for PIP contractures less than 30 deg, but be aware that contractures
can rapidly worsen during growth spurts;
- Operative Treatment:
- if required, aberrant lumbrical is excised & FDS is transferred to lateral band from dorsal
or combined dorsal & volar approach;
-
FDS release may be indicated in younger children;
- FDS transfer to extensor hood, if the digit is passively correctable may be performed in older children;
Camptodactyly: classification and results of nonoperative treatment.
