Reported functional impacts because of this reduction in ROM include difficultly in grasping objects, shaking hands, putting on gloves, completing self-care tasks, and putting the effected hand in a pocket (Hogan & Nunley, 2006 Wollstein, Rodgers, Ogden, Loeffler, & Pearlman, 2012). The clinical presentation of a FFD typically demonstrates an extension deficit, however, a loss in both flexion and extension range of motion (ROM) may be observed. Such factors include immobility or poor positioning following the initial acute trauma, post-traumatic shortening or adherence of the soft tissues, and scar and oedema formation of the surrounding structures (Boccolari & Tocco, 2009 Callahan & McEntee, 1986 Hogan & Nunley, 2006 Hunter et al., 1999 Kennedy, Peck, & Stone, 2000 Wu, 1991). Although a PIPJ with a FFD may present with a similar pathogenesis, the factors that result in joint stiffness can vary significantly between cases (Yang, McGlinn, & Chung, 2014). These soft tissue structures contribute to PIPJ stability, however, following injury or trauma can contribute to joint stiffness or deformity (Harrison, 1977).įixed flexion deformity (FFD), also known as flexion contracture, is a common complication following traumatic injury to the PIPJ (Hunter, Laverty, Pollock, & Birch, 1999). The joint capsule of the PIPJ is reinforced by the volar plate palmarly, the collateral and retinacular ligaments and lateral bands laterally and medially, and the triangular membrane and central bands dorsally. These anatomical features enhance the stability of the joint and ensure that the motion is limited to one degree of freedom (flexion and extension) (Comer et al., 2015).

The phalangeal head has a sagittally orientated groove and the base has a sagittally oriented ridge. The PIPJ is formed by the head of the proximal phalanx, which is shaped like a short transverse cylinder, and the base of the middle phalanx, which is concave in shape (Skirven, Osterman, Fedorczyk, & Amadio, 2011).

An understanding of the anatomy, the potential for joint instability, and treatment options are essential in the management of these injuries provided by occupational therapists in hand therapy practice (Comer, Clark, & Yao, 2015). Unfortunately, the PIPJ is uniquely vulnerable to injury and is inclined to become stiff shortly after trauma or immobilisation. It is estimated that this joint accounts for 85% of the total motion required to grasp an object (Blazar & Steinberg, 2000 Hogan & Nunley, 2006). The proximal interphalangeal joint (PIPJ) has the largest arc of motion (up to 120°) of the three joints in each digit of the hand.

Finger splint dynamic vs static