Highlights
- •New protocol as a novel option for the treatment of proximal interphalangeal joint flexion contracture.
- •First orthosis 24 hour per day application in treatment of proximal interphalangeal joint flexion contracture.
- •New orthosis design, more comfortable for the patient, allows prolonged clinical use.
Abstract
Introduction
This case report details the application of a treatment regimen using a serial elastic
tension digital neoprene orthosis (ETDNO) protocol for a patient with an eight-month-old
finger crush injury who experienced recurrence of a 45º proximal interphalangeal joint
(PIPJ) flexion contracture two months after arthrolysis.
Purpose of the Study
To illustrate how the application strategy of ETDNO can increase the daily total end
range time (TERT) and modify finger stiffness.
Results
The patient reached full extension following 15 weeks of ETDNO treatment. The six-month
follow-up evaluation revealed that the PIPJ was stable with full flexion and extension.
The joint did not require continued orthosis use.
Discussion
The literature describes orthosis application as the treatment of choice for PIPJ
flexion contracture, but no study has described an ideal program for use nor the full
and stable resolution of the flexion contracture. The current literature describes
a maximum daily total end range time (TERT) of 12 hours a per day. The serial ETDNO
protocol that this study described increased the daily TERT to nearly 24 hour per
day and demonstrated an excellent result in the treatment of PIPJ flexion contracture
Conclusion
This outcome suggests that clinicians will want to consider this new orthosis design
and management protocol as a novel option for the treatment of PIPJ flexion contracture.
We need future research to better define the optimum number of hours of daily TERT
for the effective treatment of PIPJ flexion contracture. In addition, we will also
benefit from the exploration of the optimum orthosis design to enable the highest
amount of TERT
Keywords
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Article info
Publication history
Published online: July 28, 2022
Accepted:
June 8,
2022
Received in revised form:
March 19,
2022
Received:
August 9,
2021
Publication stage
In Press Corrected ProofFootnotes
Competing or conflict of interest statement: There is no conflicts of interest.
Identification
Copyright
© 2022 Published by Elsevier Inc.
