Camptodactyly is a clinical or imaging descriptive term where there is a flexion contracture (usually congenital). Classically this occurs at the proximal interphalangeal joint of the little finger of the hand, although any finger may be affected.
Prevalence ~1%; one-third unilateral, two-thirds bilateral ref.
The age of presentation can vary from being detected in utero in an antenatal scan or as an obvious deformity after birth or in childhood.
There is often thought to be an abnormal insertion of the lumbrical or flexor digitorum tendons into the hand.
It can occur sporadically or with an autosomal dominant inheritance with variable penetrance and expressivity.
While it can occur in isolation, there are numerous associations with the presence of camptodactyly (especially if detected on obstetric imaging):
- aneuploidy syndromes 3
- non-aneuploidy syndromes
- other conditions causing an arthrogryposis
- isolated anomaly of the little finger, presents in infancy and affects males and females equally
- most common form
- type II
- severe contractures, multiple digits involved, presents at birth
- usually associated with a syndrome
- specific deformity of small finger distal phalanx with volar-radial curvature (apex dorsal-ulnar)
- often affects preadolescent girls
- often bilateral
- usually no functional deficits
The involved joint is flexed and often cannot be straightened. The phalangeal head may be small and if the flexion contracture is severe enough, the phalangeal head may articulating with and erode the dorsal cortex of the neck of the proximal phalanx.
Treatment and prognosis
- non-operative: stretching or splinting
- operative: lumbrical insertion excision +/- FDS release or transfer
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