[Flexion contractures of the PIP joints: pathogenesis, classification and results following arthrolysis]

The stiff proximal interphalangeal joint - an unsolved problem?

The proximal interphalangeal joint is critical for good hand function. Its anatomical complexities often predispose it to stiffness, involving damage to one or more structures. Improving or resolving the stiffness and increasing the range of motion require an accurate assessment and understanding of the pathogenesis. The surgical strategy can then be tailored accordingly. In some cases, restoration to pre-injury level may not be possible and this condition still represents an unsolved problem in hand surgery.Level of evidence: V.

[Contracture release of PIP and MP joints : classification, technique and results]

With regard to finger joint contractures, proximal interphalangeal (PIP) flexion contractures and metacarpophalangeal (MP) extension contractures are of utmost clinical importance. Exact clinical examination allows differentiation between pure joint contractures and complex cases. For PIP flexion contractures, a midlateral incision is preferable to a palmar approach, if possible. In this article, the indications, surgical techniques, and postoperative management concerning PIP flexion and MP extension contractures are addressed, and published results are discussed. Complete surgical contracture release, consistent postoperative treatment, and good compliance are the prerequisites for satisfying results.