Treatment of congenital joint contracture of the hand

Objective To discuss the surgical options for treatment of congenital joint contracture of the hand. Methods Eight cases (23 fingers) of congenital joint contractures of the hand were treated. The contractured joints were released to full extension at passive motion intraoperatively by releasing the joint capsule and volar plate, dividing insertion of the flexor digitorum superficialis, tendon lengthening by alternating the superficial and deep flexor tendons, and skin grafting. The extended joints were fixed by Kirschner wire and immobilized by plaster postoperatively. Results Primary wound healing was achieved in all 23 cases. Follow-up period was 12 to 25 months. Joint function and finger appearance were good. Except for one patient (4 fingers) who had mild tendon adhesion, 7 cases 14 fingers (metacarpophalangeal joint in 1 finger and proximal interphalangeal joint in 13 fingers) achieved normal active and passive range of motion. The rest had extension lag = 5° to 10°. Conclusion Choosing joint release procedures based on the severity of joint contractures can lead to good function. Key words: Hand deformities,congenital;  Treatment outcome;  Arthrogryposis