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Etiology, Evaluation, and Management Options for the Stiff Digit

Catalano, Louis W. III, MD; Barron, O. Alton, MD; Glickel, Steven Z., MD; Minhas, Shobhit V., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 20, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.5435/JAAOS-D-18-00310
Review Article: PDF Only

The stiff digit may be a consequence of trauma or surgery to the hand and fingers and can markedly affect a patient's level of function and quality of life. Stiffness and contractures may be caused by one or a combination of factors including joint, intrinsic, extensor, and flexor tendon pathology, and the patient's individual biology. A thorough understanding of the anatomy, function, and relationship of these structures on finger joint range of motion is crucial for interpreting physical examination findings and preoperative planning. For most cases, nonsurgical management is the initial step and consists of hand therapy, static and dynamic splinting, and/or serial casting, whereas surgical management is considered for those with more extensive contractures or for those that fail to improve with conservative management. Assuming no bony block to motion, surgery consists of open joint release, tenolysis of flexor and/or extensor tendons, and external fixation devices. Outcomes after treatment vary depending on the joint involved along with the severity of contracture and the patient's compliance with formal hand therapy and a home exercise program.

From the Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.

Dr. Catalano or an immediate family member serves as a paid consultant to Smith and Nephew. Dr. Barron or an immediate family member has received IP royalties from and serves as a paid consultant to Extremity Medical and serves as a board member, owner, officer, or committee member of the American Shoulder and Elbow Surgeons and the American Society for Surgery of the Hand. Dr. Glickel or an immediate family member serves as an unpaid consultant to Acumed, LLC and serves as a board member, owner, officer, or committee member of the American Society for Surgery of the Hand. Neither Dr. Minhas nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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