Volar Capsulodesis With Early Active Motion for the Treatment of Chronic Proximal Interphalangeal Joint Hyperextension Deformity.

Purpose: We evaluated the clinical outcomes of a series of patients with hyperextension deformity of the proximal interphalangeal joint treated with volar capsulodesis.

Methods: This retrospective study included 16 patients with symptomatic locking of the proximal interphalangeal joint who underwent volar capsulodesis and were followed for at least 2 years. We excluded patients with severe, degenerative changes on plain radiographs. Clinical evaluation included the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire; Catalano's scale for proximal interphalangeal joint hyperextension deformity correction; a visual analog scale for pain; range of motion; and grip strength. Hyperextension recurrence and residual flexion contracture were also recorded.

Results: There were 2 women and 14 men, with a mean age of 36 years (range, 22-60 years). The mean preoperative pain scores according to the visual analog scale were 3.6 (range,1-8) and 0.5 (range, 0-3) at the final follow-up. No patient had a recurrence of the hyperextension deformity. The average Quick Disabilities of the Arm, Shoulder, and Hand score was 5, and the mean grip strength was 87% of the contralateral side. Five patients were rated as having excellent results, 9 patients as having good results, and 2 patients as having fair results. Residual flexion contracture was less than 10° in 13 patients and more than 10° in 3 cases. All patients returned to unrestricted activities.

Conclusion: Volar capsulodesis with early active motion demonstrated favorable results and could be considered as a surgical option for the treatment of chronic hyperextension deformity of the proximal interphalangeal joint.

Type Of Study/level Of Evidence: Therapeutic IV.