Camptodromy

Camptodromy is a term used to describe a bending or flexion deformity of a finger joint, most commonly involving the proximal interphalangeal (PIP) joint. It can present congenitally or develop during childhood and may be bilateral or unilateral. The condition is often described as a fixed or progressive flexion contracture that limits extension of the affected finger.

Causes and pathophysiology vary and can include congenital anomalies of soft tissues, tendon or pulley system, and intrinsic hand muscles. Abnormalities of the flexor tendons, such as tight or malpositioned flexor digitorum superficialis slips, or imbalance among hand muscles, can contribute. In some cases, camptodromy is associated with syndromic conditions or other hand deformities. The exact mechanism may be dynamic, fixed, or a combination of both.

Clinical features typically include a nonpainful flexion posture at the PIP joint, reduced range of motion, and functional impairment affecting grip or hand use. The deformity may progress over time, particularly with growth in pediatric patients.

Diagnosis is clinical, supported by physical examination and assessment of accessory joints and tendon function. Imaging, such as radiographs, helps evaluate joint integrity and exclude arthritic or osseous causes. Differential diagnoses include other finger deformities such as boutonnière or swan neck deformities.

Treatment ranges from observation for mild cases to conservative measures like splinting, serial casting, and hand therapy. Surgical options, considered for persistent or severe deformities, include tendon lengthening or release, joint capsulotomy, or correction of associated soft-tissue abnormalities. Prognosis varies with severity and underlying cause.