Case Study – 3

Trauma,Courtesy of Alonso Escalante, MD

Six months prior to being referred to Dr. Escalante, this female patient hyperextended her ring finger. Prior splinting had not been successful in reducing her contracture and she presented with a 90º flexion contracture of her ring finger PIP joint.

It was decided to use a Digit Widget to treat the contracture. Nine weeks after the device was installed, the contracture was corrected to nearly full extension. However, when the elastic band tension was removed, the joint would lose extension within a few days.

After 14 weeks of wearing the device, the patient had exploratory surgery in her palm. Bone pins were left in the middle phalanx. Exploration of the flexor tendons revealed a rupture of the FDP tendon, with adhesions to the FDS tendon. Dr. Escalante performed a tenolysis and the FDP was excised.
This case illustrates how the Digit Widget can assist in revealing the underlying etilogy of a PIP contracture. As the joint moves throughout a more normal arc of motion, the cause of the contracture can be more easily identified. The Digit Widget was worn for another four weeks and her final PIP motion was 30 – 90º.

Case Studies

Courtesy of John Agee, M.D.

Case Study - 1

Dupuytren's Contracture

Courtesy of John Agee, M.D.

This case study involves an 83-year-old man with severe Dupuytren’s Contracture of the PIP and MCP joints of his long and ring fingers. He has had no prior surgery. The patient sought treatment because he was no longer able to hold a golf club. Prior to performing a fasciectomy, Dr. Agee decided to use Digit Widgets on both affected fingers to facilitate access to the palm and fingers. The Digit Widgets were applied and the Dupuytren’s bands in the palm were cut, but not excised.

Courtesy of Robert Slater, MD

Case Study - 2

Trauma

Courtesy of Robert Slater, MD

A 35 year-old man injured his right ring finger during a martial arts training session. Nine months later, he was referred for treatment of a persistent finger deformity that was painful and limited hand function. Previous attempts at serial plaster casting and dynamic splints failed to improve the finger’s ROM.

Courtesy of Alonso Escalante, MD

Case Study - 3

Trauma

Courtesy of Alonso Escalante, MD

Six months prior to being referred to Dr. Escalante, this female patient hyperextended her ring finger. Prior splinting had not been successful in reducing her contracture and she presented with a 90º flexion contracture of her ring finger PIP joint.

Courtesy of WB Ericson, M.D.

Case Study - 4

Dupuytren's Contracture

Courtesy of WB Ericson, M.D.

This patient is a healthy 60 year old white male who presented with isolated bilateral severe contractures of the small finger PIP joints (~110º) from Dupuytren’s disease.

Courtesy of John Agee, M.D.

Case Study - 5

Dupuytren's Contracture

Courtesy of John Agee, M.D.

This case study involves a 73 year-old female with severe Dupuytren’s Contracture of the MCP and PIP joint of the little finger on her left hand. She had no prior surgeries on the left hand. Before surgery, her MCP joint lacked 75º and the PIP joint lacked 80º. During surgery a fasciectomy was performed and one Digit Widget was applied.