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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Camptodactyly



- 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.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, May 22, 2012 9:40 am