postoperative care

Last reviewed 01/2018

Postoperative care for camptodactyly entails an intensive regimen with dedicated hand therapists. At three weeks, if a wire has been sited across the proximal interphalangeal joint (PIPJ), this is removed. A thermoplastic splint is manufactured with the metacarpophalangeal joint in 70 degrees of flexion and the interphalangeal joints straight. This has the effect of encouraging the extrinsic extensors to extend the PIPJ and takes tension off a transferred flexor digitorum superficialis (FDS) transfer to the extensor side. If an FDS transfer has been undertaken, a graduated program of exercise is taught that entails relearning that FDS contraction stimulates PIPJ extension. Initial isometric extension exercises are gradually changed to PIPJ range of motion regimes. Finally, increasing resistance is applied to extension. The transfer may require splint protection when not doing exercises for up to three months. Splinting at night is encouraged beyond that until the patient has gone beyond the phase of digital growth, typically early adulthood.

Scar therapy may entail regular massage, silicone gel products or ultrasound therapy.