TOTAL COLLATERAL LIGAMENT EXCISION FOR CONTRACTURES OF THE PROXIMAL INTERPHALANGEAL JOINT

The complete excision of scarred proximal interphalangeal collateral l igaments as the cornerstone of surgical treatment for proximal interph alangeal joint contractures was evaluated. Supplemental palmar plate d istal release, extensor tenolysis, and flexor sheath release were perf ormed as needed. Sixteen patients with primary proximal interphalangea l joint contractures treated by this method were reviewed with the use of preoperative data obtained from chart review and postoperative dat a from direct patient examination. The average range of motion increas ed from 38 degrees to 78 degrees. No patients had instability of the p roximal interphalangeal joints on manual testing and x-ray examination . This radical surgical approach to contracted proximal interphalangea l joints is justified by the improved range of motion without instabil ity.