Treatment of posttraumatic contractures of the proximal interphalangeal joints in the fingers

Abstract

Post-traumatic contractures of the proximal interphalangeal joint are a common problem. They arise as a result of a violation of the delicate balance between the bone and soft tissue structures of the joint. The treatment of this pathology is complicated and leads to full function restoration only in 36% of patients.
 The literature review presents the analysis of domestic and foreign scientific literature devoted to the treatment of post-traumatic contracture of the finger joints. The purpose is to systematize the methods and, subsequently, derive a unified approach to the treatment of this pathology.
 In total, 67 papers were collected in foreign and domestic scientific databases, in English and Russian language, in the period limited to December, 2021. They describe 8 extended treatment methods, both conservative and surgical. The non-surgical methods include physiotherapy, the use of various types of fixatives, injections of hyaluronic acid preparations and platelet-rich plasma, followed by exercise therapy. The surgical methods are represented by arthrodesis, arthroplasty, arthrolysis and joint distraction using an external fixation device. The techniques are described in the order of increasing effectiveness, each of them is used with varying success and cannot be considered as a gold standard treatment for this pathology. In the studied literature, the possible combination of the techniques was not mentioned, thought it could be possible, if we consider the pathogenetic mechanisms of the development of contractures, and may provide better treatment results.