Pointing Out When to Release a Stuck FingerThe fingers each have three separate joints to give the hand its arc of motion when bending and straightening. Each joint has a specific name. The joint in the middle is called the proximal interphalangeal joint, or PIP joint.
Loss of motion in the PIP joint can cause real problems doing daily activities. If more than one finger is involved, the patient can lose the ability to flex or extend the fingers. Sometimes, both motions are restricted. When the joint is "stuck" and can't bend or straighten, it's called a contracture.
Treatment for problem joints includes therapy with an occupational or physical therapist. Surgery may be needed if therapy doesn't get the desired results. Surgery isn't always helpful. For this reason, doctors would like to be able to tell which patients will do well with surgery. They want to avoid doing surgery on patients who won't get better.
A study from the Curtis National Hand Center in Baltimore, Maryland, has given some advice about which patients should consider surgery. Patients with PIP contractures do well with surgery if they are younger than 28 years and have a simple diagnosis. "Simple" problems include breaks, dislocations, cuts, and injuries to the ligaments. More serious or "complex" problems include patients with poor circulation, crush injuries, or severe pain patterns.
Careful selection of patients with PIP contractures can help create a good result after surgery. Younger patients with more motion and fewer serious finger problems do best with surgery to release the contracture.
Sean D. Ghidella, MD, et al. Long-Term Results of Surgical Management of Proximal Interphalangeal Joint Contracture. In The Journal of Hand Surgery. September 2002. Vol. 27A. No. 5. Pp. 799-805.
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