What Is Camptodactyly?

Camptodactyly (from the Greek kamptos, bent, and daktylos, finger) is a congenital or acquired, non-traumatic flexion deformity of one or more fingers at the proximal interphalangeal (PIP) joint. It most commonly affects the little finger, is bilateral in approximately two-thirds of cases, and ranges in severity from mild functional limitation to rigid fixed deformity. Congenital forms typically present in infancy or early childhood; a second wave of presentation occurs in adolescence, particularly in females, associated with rapid growth.

The underlying pathology involves structural abnormalities of the intrinsic hand muscles, the flexor digitorum superficialis tendon, skin contracture, or collateral ligament tightening — often in combination. The specific aetiology varies by presentation and may be idiopathic, associated with connective tissue disorders (including Ehlers-Danlos syndrome and Marfan syndrome), or part of a syndrome complex such as arthrogryposis or trismus-pseudocamptodactyly syndrome.

Assessment and Management

Assessment distinguishes passively correctable from fixed deformities. Passively correctable camptodactyly — where the PIP joint can be brought to full extension with the MCP joint held in flexion (relieving intrinsic muscle tension) — carries a better prognosis for conservative management and responds to splinting and stretching programmes. Fixed deformities with contracted capsular and skin structures are less amenable to conservative treatment.

Manual therapy and hand rehabilitation approaches include progressive PIP extension splinting (static progressive or dynamic), intrinsic muscle stretching, scar mobilisation in acquired cases, and joint mobilisation targeting the PIP joint capsule. Surgical intervention — releasing contracted structures and tendon lengthening or transfer — is considered when significant functional limitation persists after adequate conservative management, particularly where deformity exceeds 30–40 degrees of fixed flexion.

References & Further Reading

  1. Smith PJ, Grobbelaar AO. Camptodactyly: a unifying theory and approach to surgical treatment. J Hand Surg Am. 1998;23(1):14–19.
  2. Foucher G, Lorea P, Khouri RK, de Brug M, Sammut D. Camptodactyly. Chir Main. 2006;25 Suppl 1:S188–S197.