The use of thermoplastic material in treatment of Proximal Interphalangeal Joint Flexion Contractures

Abstract:   Objectives: Flexion contractures of the proximal interphalangeal joint are of the most common complication result from surgical procedures and traumatic events.  Orthotic interventions for treatment of contractures may include serial splinting, serial casting, dynamic and/ or static progressive orthoses, or a combination of these orthoses.  This study aimed to determine the effect of serial casting methods with thermoplastic material in PIP joint flexion contracture treatment. Method: Thirty-one patients with flexion contracture of the PIP joint; (mean:  32.5°/ range from: 10°-65°) were treated by serial casting method with thermoplastic material. Flexion contracture, Total active motion, extension lag and flexion gap were evaluated in the first session. The affected joint was casted after hand therapy interventions. Patients were asked to come back to clinic every other day for recasting and receiving exercises. Results: After of one month, the mean range of flexion contracture decreased from 32.5° to 10.7°. The mean range of flexion gap, decreased from 3.2 cm to 1.8cm. The mean range of extension lag decreased from 2.04 cm to 0.86 cm, and the mean range of total active motion increased from 81.67° to 128.81°. All of the aforementioned changes were statically significant (p<0.05). Discussion: Use of thermoplastic material for serial casting method is an effective and reliable method for the treatment of PIP joint flexion contracture.