Soft tissue distraction using pentagonal frame for long-standing traumatic flexion deformity of interphalangeal

Abstract

【Abstract】Objective: Interphalangeal joint con-tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture re-lease and partial ligament transection and volar plate removal. Methods: In this prospective study, a total of 40 pa-tients in two equal groups (A and B) were studied. Patients suffering from chronic flexion contracture of abrasive trau-matic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting. Results: Analyzed data revealed a significant differ-ence between the two groups for range of motion in the proximal interphalangeal joints (P<0.05), while it was not meaningful in the distal interphalangeal joints (P>0.05). There was not a significant difference in the degrees of flexion contracture between groups (P>0.05). Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proxi-mal interphalangeal joints (P<0.001), while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention (P<0.001). Conclusion: Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral liga-ment and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of mo-tion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints. Key words: Osteogenesis, distraction; Finger joint; Hand deformities