Congenital flexion deformities of the proximal interphalangeal joint in children: a subgroup of camptodactyly.

Severe flexion contractures of the proximal interphalangeal joint that are present at birth affect both sexes equally, often involve several digits of the same hand, and show no predilection for the small finger make up a distinct subgroup of the deformity known as camptodactyly. In this series, 20 digits with such severe flexion contractures were treated surgically. In eight digits, the flexor digitorum superficialis tendon was lengthened with or without release of contracted palmar structures. There was no improvement in these digits. In the other 12 digits, the extensor mechanism was realigned and augmented by release or transfer of the flexor digitorum superficialis tendon. All 12 of these digits had good (n = 10) to fair (n = 2) improvement in active and passive extension while retaining adequate flexion, although 9 still had some residual flexion contracture. In this type of camptodactyly, extensor mechanism anomalies appear to be the primary lesion.