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Penning Fixator and its role in severe congenital finger contractures
Zulfiqar ALI Chaudhry, FRCS1, Hassan Shafiq, MRCS2 and Muhammad Shibu, FRCS(P).1, (1)Royal London Hospital,London., London, United Kingdom, (2)Royal London Hospital,London, London, United Kingdom

Camptodactyly is a congenital, often progressive flexion contracture of proximal interphalangeal joint (PIPJ) affecting the little and ring finger. After the publication by Tamplin in 1846, there has been much debate and discussion regarding its aetiology and treatment1.True incidence of camptodactyly is not known but it is estimated to involve less than 1 % of the population2. Bensun and colleagues 3 have classified Camptodactyly into three subgroups.
Type 1-Classical, present in infancy, typically confined to one or both little fingers but other fingers may also be involved.
Type 2- present in adolescents.
Type 3-Severe form, involve multiple digits.
Material and Methods
Different surgical techniques have been described to treat severe Camptodactyly (PIPJ contracture more than 60 degree) in the literature. We have introduced a new method of management in 10 cases done at Royal London Hospital, London.
In the first stage, a Penning fixator was applied to lengthen the contracted soft tissues of the finger. 3-6 months later FDS was transferred to extensor mechanism of the finger in second stage. This was followed on by splintage and rehabilitation in physiotherapy.
Results
At the end of treatment all 10 patients had nearly straight fingers with good range of motion at the PIPJ. There was no recurrence early follow up.
Conclusion.
Soft tissue lengthening with Penning fixator and FDS transfer to extensor system in Camptodactyly is a effective ,reliable procedure with good result. Recurrence can be prevented by regular follow up and physiotherapy.


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