Effects of serial casting in the treatment of flexion contractures of proximal interphalangeal joints in patients with rheumatoid arthritis and juvenile idiopathic arthritis: A retrospective study

Abstract

AimTo analyze the effects of serial casting (SC) in the treatment of proximal interphalangeal (PIP) joint flexion contractures in patients with rheumatoid arthritis and juvenile idiopathic arthritis. Study designRetrospective case-series. MethodsThe data of 18 patients treated with SC were obtained from their patient records. The angular changes in the finger joints were analyzed and compared statistically using t-tests. ResultsA total of 49 fingers were serially casted with plaster of Paris over a 14-year period. The SC resulted in significant (26.8°; p < 0.001) reduction in the PIP joint extension loss. Small, but statistically significant, losses in flexion were associated with these gains. (p < 0.001). Angular changes were also observed in the other finger joints. The magnitude of the initial extension loss was the only factor to explain the amount of motion gained (p < 0.001; R2 = 0.38). ConclusionSC is an effective method to correct flexion contractures in PIP joints in selected patients with arthritis. The gain is partially related to the magnitude of initial extension loss.