Further surgery carries high risk of complications and poor outcome. Historically, collagenase injections have had correction rates of 77% for MCP contractures and 40% for PIP contractures. for the treatment of contractures may include serial splinting, serial casting, dynamic or static progressive orthoses, or a combination of these orthoses. In a 2-month study of 19 patients, we assessed whether dynamic splinting could decrease proximal interphalangeal (PIP) flexion contractures. In these 2 patients with claw deformity, we found that tight volar skin was the main contributor to flexion contracture at the PIP level. Of the eight patients who completed the study, one experienced a statistically significant improvement in PIP range of motion as a result of the splinting. For joint extension to be maintained following device removal, the surgeon must formulate a treatment plan tailored to the unique findings in each patient and in each digit. F lexion contracture of the proximal interphalangeal (PIP) joint is a common clinical problem that can occur as a result of the most innocuous injury. Referral to a hand surgeon is indicated if the MCP joint contracture reaches 30 degrees or if PIP joint contracture occurs at any degree.2 The Hueston tabletop test is a good indication for referral. Pull is volar to the MP and dorsal to the IP. Objectives: Flexion contractures of the Proximal Interphalangeal joint are the most frequent complications resulting from surgical procedures and traumatic events. Either there is not enough extensor force, too much flexor force, or a combination of the two. Proximal interphalangeal joint flexion contracture is a common and persistent problem in hand rehabilitation. The Digit Widget reverses these contractures by utilizing the principle that gentle force applied over time will stimulate growth of contracted soft tissues. Patients are often offered finger amputation. Full finger flexion\ഠdemand elongation of the interosseous muscles. PIP joint contractures are more … At the PIP joints, the volar plates were released and the tight palmar skin was released, resulting in marked improvement of joint position. 2,3,12 . Recurrent severe Dupuytren contracture of the small finger’s proximal interphalangeal (PIP) joint is a difficult problem. A successful correction with a CCH injection is defined as being <5° of flexion contracture at 30 days post injection [10, 11]. However, the flexion contracture is symptom of an underlying problem involving a torque imbalance at the PIP joint. Movement at this joint is responsible for 85% of the total composite motion of the digit. This article discusses the advantages and disadvantages of several current splint designs for correcting this contracture and introduces an alternate design that uses wire in a 3-point pressure system. PIP flexion contractures result from a torque imbalance across the joint. 1 Hence, severe flexion deformity can lead to marked loss of global hand function and hinders activities of daily living. •Decreased PIP passive flexion with MP passive extension •Lumbrical tightness? This study aimed to determine the effects of serial casting methods using thermoplastic tape in the Proximal Interphalangeal (PIP) joint flexion contracture treatment. Orthotic interventions for the treatment of contractures may include serial splinting, serial casting, dynamic or static progressive orthoses, or a combination of these orthoses. Intensive hand therapy was used to maximize function. 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