Severe camptodactyly: A systematic surgeon and therapist collaboration

Netscher, David T.; Staines, Kimberly Goldie; Hamilton, Kristy L.

doi:10.1016/j.jht.2014.12.004

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…One study also used PIP joint skeletal changes noted on radiograph as a surgical indication (the exact radiographic change was not described). 23…”

Section: Resultsmentioning

confidence: 99%

“…Three studies included 7 adult patients, and one study included 22 patients who were not treated; these patients were excluded. Three articles [21][22][23] likely studied overlapping patient populations because they were authored by the same research group with overlapping patient recruitment periods. We included all 3 articles in the qualitative analysis as each had a different aim, so their conclusions still uniquely contributed to the overall understanding of camptodactyly; however, we only included quantitative results from the most recent article of the three 23 when aggregating outcomes data.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Surgery and Conservative Management of Camptodactyly in Pediatric Patients: A Systematic Review

Wang

Kim

et al. 2019

Hand (New York, N,Y.)

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Camptodactyly is a pediatric hand condition, the treatment of which remains controversial. The authors' aim was to improve patient care through clarifying the definition of camptodactyly and indications for surgical and/or conservative management, summarizing outcomes, and defining risks. A systematic review was conducted of articles in all languages on outcomes following surgical and/or conservative management of idiopathic camptodactyly in children using MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, EMBASE (Excerpta Medica database), AMED (Allied and Complementary Medicine), and CINAHL (Cumulative Index of Nursing and Allied Health Literature) (until January 2017). The primary outcome was posttreatment flexion contracture, and the secondary outcomes were indications for surgery, complications, and patient satisfaction. Database searching generated 16 final articles, with 7 case series and 9 retrospective cohort studies. There was a lack of consistency on the definition of camptodactyly and in outcome reporting. All 16 studies received a "Weak" global rating and demonstrated low-quality evidence, suggesting that treatment of camptodactyly with operative or nonoperative measures reduces the degree of flexion contracture in most patients (from pretreatment averages of 20°-85° to posttreatment averages of 5°-37°). There was general agreement that surgery should be reserved for contracture >30° or failure to respond to conservative management. Surgery generally led to more complications compared with conservative management. Only one study reported on functional limitations, and another reported on patient-reported outcomes. Current evidence of the effectiveness of camptodactyly treatment in addressing both joint-specific deformity and patient-perceived function and appearance is insufficient to guide patient care. Future research may consider the development of decision aids to guide patients and families through selecting management strategies and to promote shared decision making.

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“…One study also used PIP joint skeletal changes noted on radiograph as a surgical indication (the exact radiographic change was not described). 23…”

Section: Resultsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Surgery and Conservative Management of Camptodactyly in Pediatric Patients: A Systematic Review

Wang

Kim

et al. 2019

Hand (New York, N,Y.)

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“…The study by Evans et al 8 involved 31 digits in 22 patients (7 of which were type I, 8 were type II, and 7 were type III), and found no significant improvement in total range of motion of the PIP joint following surgical treatment, with improvement only observed in the extension arc of the digit. However, in the studies by Netscher and Hamilton et al involving 18 patients with type I or II camptodactyly 9 , satisfactory results were achieved with a stepwise surgical release strategy, with 15 patients (83.3%) achieving full active range of motion of the PIP joint. With this approach, successful release can be determined based on passive flexion and extension of the digit during the operation itself.…”

Section: Discussionmentioning

confidence: 97%

Modified radial tongue-shaped flap following stepwise surgical release for Benson type I camptodactyly of the 5th digit

Liao

Wang²,

Tang³

et al. 2023

Sci Rep

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To investigate the outcomes of the modified radial tongue-shaped flap following stepwise surgery release for treating Benson type I camptodactyly of the 5th digit. A retrospective analysis involving patients with Benson type I camptodactyly of the 5th digit was performed. A total of 8 patients with 12 affected digits were included. Extent of surgical release depended on the degree of soft tissue contracture. Skin release, subcutaneous fascial release, and flexor digitorum superficialis tenotomy were performed in all 12 digits, sliding volar plate release in 2 digits, and intrinsic tendon transfer in 1 digit. The mean total passive motion of proximal interphalangeal joint significantly increased from 32.5° ± 16° to 86.3° ± 20.4°, while mean total active motion significantly increased from 22° ± 10.5° to 73.8° ± 27.5° (P < 0.05). Treatment outcomes were excellent in 6 patients, good in 3, moderate in 2, and poor in 1. Scar hyperplasia occurred in 1 patient. The radial tongue-shaped flap allowed for full coverage of the volar skin defect, and was considered aesthetically favorable. In addition, the stepwise surgical approach not only achieved good curative effects, but also allowed for individualization of treatment.

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“…Siegert et al [3] reported that more than 50% of patients complained about a loss of flexion after surgery. Additionally, previous studies reported that, to correct camptodactyly, a release of the FDS was usually performed [3][4][5][6][7]12,13,19,20]. However, the excessive lengthening or tenotomy of the FDS gives rise to a decrease in the active arc of motion and a loss of flexion, even if the procedure was able to provide a better extension of the PIP joint [7].…”

Section: Discussionmentioning

confidence: 99%

One-Stage Extension Shortening Osteotomy for Syndromic Camptodactyly

Park

Kim

Park

et al. 2020

JCM

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Syndromic camptodactyly often affects multiple fingers, and severe deformities are common compared to idiopathic camptodactyly. This study aimed to evaluate the use of a one-stage extension shortening osteotomy of the proximal phalanx for patients with syndromic camptodactyly without tendon surgery. Forty-nine cases of syndromic camptodactyly were included. Forty fingers (81.6%) were associated with arthrogryposis multiplex congenita, and nine (18.4%) with other syndromes. Six fingers presented with a moderate form (30° to 60°) of camptodactyly, whereas 43 fingers manifested the severe form (>60°). The mean age at the time of surgery was 8.5 years, and the patients were followed for a mean of 3.9 years. The mean length of the shortening of the proximal phalanx was 4.9 mm, which averaged 17.8% of the proximal phalanx’s original preoperative length. The mean operative time was 25.8 min, and the PIP joint was fixed using Kirschner wires with an average flexion position of 7.6°. The mean flexion contracture improved from 76° preoperatively to 41° postoperatively. The mean preoperative active arc of motion was 23°, which improved to 49° postoperatively. A one-stage extension shortening osteotomy is a straightforward and effective technique for the improvement of finger function through the indirect lengthening of volar structures without the flexor tendon lengthening. The osteotomy could simultaneously correct bony abnormalities. This simple procedure is especially suitable for surgery on multiple fingers in patients with syndromic camptodactyly.

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Severe camptodactyly: A systematic surgeon and therapist collaboration

Cited by 9 publications

References 13 publications

Surgery and Conservative Management of Camptodactyly in Pediatric Patients: A Systematic Review

Surgery and Conservative Management of Camptodactyly in Pediatric Patients: A Systematic Review

Modified radial tongue-shaped flap following stepwise surgical release for Benson type I camptodactyly of the 5th digit

One-Stage Extension Shortening Osteotomy for Syndromic Camptodactyly

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