الفهرس | Only 14 pages are availabe for public view |
Abstract The stiff finger refers to a reduction in the range of motion in the finger, and it is a condition that has many different causes and involves a number of different structures. Almost all injuries of the fingers and some diseases can cause finger stiffness. Hand surgeons often face difficulty treating stiff fingers that are affected by irreversible soft tissues fibrosis. Stiff fingers can be divided into flexion and extension deformities. They can also be sub-classified into four categories according to the involved tissues extending the skin to joint capsule. Prevention of stiff fingers by early mobilization of the joint is prudent to avoid more complicated treatment after established stiffness occurs. Static progressive and dynamic splints have been considered as effective non-operative interventions to treat stiff fingers. When severe deformity exists or intra-articular fracture or vascular status of the finger has been compromised, arthrodesis or amputation should be considered instead of procedures to regain motion. Surgical release most commonly leads to mild improvement in the flexion contracture and a shift of the flexion \ extension arc into more functional range. Prior incisions should be incorporated, but if the finger has not previously undergone surgery, a mid lateral approach is preferred. Release should proceed from proximal to distal and extra- articular to intra-articular of PIP joint to allow for intraoperative assessment of progress. Close follow up with weekly hand therapy and urgent early active and passive motion and night splint continued for six month postoperative. |