Congenital extension contracture of metacarpophalangeal joints

Dynamic External Fixator as Treatment for Congenital Little Finger Contracture

The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year. The symptom started after trauma on his hand while playing lacrosse. Further examination revealed that his MP joint was congenitally contracted. To address this pathology, DEF followed by orthotic therapy was done. Two years after the procedure and therapy, the MP joint ROM of the finger surpassed that of the contralateral unaffected digit without pain and recurrence. The patient was able to return to his sports of lacrosse.

Idiopathic extension contracture of the little metacarpophalangeal joint

We describe 4 patients with an extension contracture of the little metacarpophalangeal joint without definite cause. We encountered this entity only in adolescent girls. When treated conservatively, we observed no improvements in motion. The main pathology of this entity was a hypertrophied dorsal capsule. The 2 patients treated by surgical release of the fifth dorsal capsule and collateral ligaments achieved considerable flexion 2 years later.