chapter  11
6 Pages

Percutaneous Release of the Post-traumatic Finger Joint Contracture: A New Technique

Finger joint stiffness can result in severe impairment of hand

function and is a difficult problem to treat. Stiffness can result

from injury, infection, excess immobilization, and inap-

propriate splinting (1). An accumulation of fluid or blood

within the capsule after trauma will subsequently lead to

stiffness. The open surgical management of joint contractures

has led to unpredictable results, with some conditions

actually worsening postoperatively (2). The lack-luster

results of open release of the proximal interphalangeal (PIP)

joint have led some surgeons to try less invasive or indirect

means of contracture release. These methods, such as external

fixators, have shown some early promise in regaining some

motion, but are associated with high complication rates (3).

It has been suggested that the results of open surgical release

of flexion contractures greater than 608 (1) is so poor that

arthrodesis is the preferred treatment. We describe a mini-

mally invasive technique for the surgical release of selected

joint contractures, through percutaneous surgical release of

pathologic structures alone, avoiding injury to normal

structures and reducing postsurgical swelling and pain.

The reduction in pain and swelling allows for an accelerated

rehabilitation program and a more complete recovery of

hand function.