Management

The management of camptodactyly entails splintage and stretching physiotherapy in the first instance. Mild contractures (less than 40 degrees) give little in the way of functional problems.

Static or dynamic splinting is commenced and this can generally prevent progression of deformity. The splint is worn until early adulthood when the growth plate closes and some of the tendency to flexion contracture is reduced. A regimen of stretching is undertaken immediately prior to the reapplication of the splint every day. They must be worn day and night for several months in the first instance; only if an improvement is noted should the splint be worn for a lesser duration each day. The choice of static splint includes:

• Plaster of Paris with serial casting in increasing extension
• thermoplastic and fixed with Velcro strips; this can be continually remodelled if the digit is showing signs of straightening

In young children, they should extend to the forearm to ensure compliance.

Even with full conservative measures, straightening may occur only in 20% of cases and progression is one of the indications for surgical intervention - see submenu.