> ## Content Index > Fetch the complete content index at: https://www.theplasticsfella.com/llms.txt > Use this file to discover other available public pages before exploring further. # Camptodactyly: Features, Classification, & Management - URL: https://www.theplasticsfella.com/camptodactyly/ - Published: 2024-04-23T18:44:00.000Z - Updated: 2024-04-24T18:34:36.000Z - Description: Camptodactyly is the progressive flexion deformity of the PIPJ. This article details the aetiology, features, classification, and management of this congenital hand condition. - Author: PlasticsFella - Tags: Upper Limb, Paediatrics #### Summary Card [****Definition of Camptodactyly**](https://www.theplasticsfella.com/camptodactyly/#definition-of-camptodactyly) Progressive flexion deformity of the PIPJ. [****Features of Camptodactyly**](https://www.theplasticsfella.com/camptodactyly/#features-of-camptodactyly) Often bilateral and little finger. An X-Ray may show secondary complications. [****Classification of Camptodactyly**](https://www.theplasticsfella.com/camptodactyly/#classification-of-camptodactyly) Classified based on onset of deformity and severity of the flexion. [****Management of Camptodactyly**](https://www.theplasticsfella.com/camptodactyly/#management-of-camptodactyly) Serial splinting and education for most patients. Surgery has a low success rate. --- ## Definition of Camptodactyly Camptodactyly is the *progressive* flexion deformity of the [proximal interphalangeal joint](https://www.theplasticsfella.com/pipj-anatomy/). Swanson classifies it as a 'failure of differentiation'. The image below illustrates the definition of Camptodactyly. ![Definition of Camptodactyly](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/08/Camptodactyly-Definition.png) Definition of Camptodactyly 💡 ****Tip:** the progressive nature of this condition is a key differentiator to arthrogryposis. --- ## Features of Camptodactyly ****Key Point** Camptodactlyly is a flexion deformity of the PIPJ that is usually the little finger and bilaterally. Radiology may show secondary sequelae. It is classified based on the onset of deformity. ### Clinical Features Camptodactyly is characterised by the progressive flexion deformity of the [proximal interphalangeal joint](https://www.theplasticsfella.com/pipj-anatomy/). It affects females more than males. Some key points include: - Abnormal flexion posture of PIPJ. - Painless without swelling. - Often bilateral and involves the little finger. Often **caused** by abnormal lumbrical insertion (HINT: pain on passive extension), short FDS tendon, and abnormal extensor mechanism. The **differential diagnosis** includes: - Traumatic PIPJ injury. - **Arthrogryposis**: congenital, ulnar deviation, multiple joints. - **Symphalangism** (failure of joint formation) if no skin creases. - Kirner’s deformity is not a differential diagnosis. This is a skeletal deformity characterised by progressive palmar and radial curvature of the **DIPJ**. 💡 ****Tip:** Examining PIPJ extension with MCPJ flexed can differentiate between intrinsic and extrinsic causes. The image below illustrates this failure of differentiation of Camptodactyly. ![Camptodactyly classification, Failure of Differentiation in Camptodactyly](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/08/Camptodactyly-features.png) Failure of Differentiation in Camptodactyly ### Radiological Signs Generally speaking, an X-Ray will not show any primary cause for the camptodactyly as its aetiology is of soft tissue origin. It can show some secondary changes, such as: - Morphological changes to the proximal phalanx. - Decrease in proximal phalanx head convexity. - Flattening at the base of the middle phalanx. - Loss of [PIPJ](https://www.theplasticsfella.com/pipj-anatomy/) joint space with volar subluxation. Check out the below image for the X-ray view of Camptodactyly. ![Camptodactyly X-ray view](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2022/08/Xray-of-Camptodactyly.png) X-ray representation of Camptodactyly 💡 ****Tip:** a flattened dorsal phalanx is often not surgically correctable. --- ## Classification of Camptodactyly ****Key Point** Camptodactyly is classified based on onset of deformity and severity of the flexion. Camptodactyly classification is based on the **onset** of flexion deformities. - **Type I:** occurs during infancy (the most common type). - **Type II:** occurs during pre-teenage years. - **Type III:** severe, multiple digits, associated with syndromes. 😎 ****Fun Fact:** Type II camptodactyly can progress to Type III. --- ## Management of Camptodactyly ****Key Point** The majority of the patients with camptodactyly can be treated conservatively with splinting and education. Surgery is unlikely to achieve a successful outcome. Patients with camptodactyly can be treated by conservative or surgical options. This depends on the extent of their severity. The majority of patients can be managed in an **outpatient setting** by: - Education - Physiotherapy - Serial Splinting or casting In a select number of patients with severe disease, **surgical** considerations can include: - FDS transfer to extensor surface - Angulation osteotomy - Fusion Surgery should be performed in a step-wise manner to release and reconstruct structures until the flexion deformity is corrected. --- ## Conclusion ## Upon completing this article, you will have accomplished the following: ****1\. Pathophysiology of Camptodactyly:** You have learned that camptodactyly is characterized by a progressive flexion deformity of the proximal interphalangeal joint (PIPJ), predominantly affecting the little finger and often presenting bilaterally. ****2\. Clinical and Radiological Features:** You are now familiar with the clinical presentation of camptodactyly, which typically includes a painless, abnormal flexion posture of the PIPJ without swelling, and how radiology can show secondary changes but not the primary cause due to its soft tissue origins. ****3\. The Classification System:** You understand the classification of camptodactyly based on the onset of the deformity and the severity of the flexion for predicting the progression and planning the management strategy. ****4\. Management Strategies:** You have understood the conservative management approaches such as education, physiotherapy, and serial splinting, and understand when surgical intervention might be considered, and its generally low success rate. ---