Camptodactyly

Camptodactyly is a rare condition where a finger — or fingers — is fixed in a bent position at the middle joint, and cannot fully straighten. Affecting less than 1 percent of the population, camptodactyly is most often found in the pinky finger and can occur in one or both hands.

Symptoms of camptodactyly often go unnoticed in a child’s early years because the condition rarely causes pain and, in most cases, does not affect the function of the hand.

Treatment varies depending on the severity of the condition, but can include stretching, splinting and surgery.

While the origin of camptodactyly remains unknown, it is believed to have a genetic component and may be linked to disruptions in prenatal development.

Camptodactyly can be caused by:

• Abnormal muscles in the hand.
• Differences in bone shape
• Tight skin
• Contracted tendons and ligaments

The main symptom of camptodactyly is a slightly flexed posture of the middle joint, where the finger cannot completely straighten. It is most common in the little finger, but may affect other fingers as well. The condition may worsen over time, and may often worsen during growth spurts.

In most cases, the condition does not cause pain or significantly affect the function of the hand. Camptodactyly does not cause swelling, inflammation or warmth to the area.

At Children's Hospital of Philadelphia (CHOP), diagnosing camptodactyly typically begins with a physical examination of your child’s fingers and hand.

In some cases, clinicians may recommend an X-ray to confirm the diagnosis. X-rays produce images of bones and help doctors identify the underlying structure of the hand.

In addition to a physical exam and X-rays, your child may also undergo:

• Range of motions tests to determine if the condition is affecting movement and dexterity
• Nerve assessment tests to determine if the condition has damaged or compressed any nerves

Accurate diagnosis helps us determine the best course of treatment for your child.

Treatment for camptodactyly will depend on the severity of your child’s condition, as well as the age and development of your child.

Nonsurgical treatment

Most cases of camptodactyly do not require surgical intervention.

If your child has a mild case of camptodactyly — less than a 30-degree bend in their finger that is not affecting hand function — nonoperative treatment will be recommended.

Nonoperative treatment may include:

• Finger and joint stretches to extend range of motion for the affected finger or fingers
• A splint to hold the bent finger in a straight position

Surgical treatment

If your child’s camptodactyly is severe, getting worse over time, or affecting their hand function, surgery may be recommended. Surgery is most effective if performed while your child is still young and the bones are not fully matured.

At CHOP, board-certified orthopaedic and plastic surgeons perform a variety of operations to repair damage and improve function for children with hand conditions.

Two common procedures are:

• Dividing the tendon that is causing the muscle shortening
• Transferring a tendon and/or muscle to restore balance to the hand

In rare cases, where a child’s camptodactyly is related to abnormal bones or bone structure, doctors may need to perform surgery to repair, remove or fuse a bone to optimize hand function. During this process some range of motion in the joint may be lost.

After surgery, your child’s finger, hand or arm may be put in a cast, splint or sling to immobilize it as it heals.

Follow-up care for camptodactyly will depend on the treatment needed. If your child received nonsurgical treatment, they should be monitored regularly to ensure the condition is not worsening.

If your child had surgery, they will be examined at 2 weeks and 6 weeks post-operatively, then monitored regularly. Your child’s doctor will give you specific information about a recovery program for your child and how soon they can return to daily activities.

The long-term outlook for children with camptodactyly is very good. While most children with the condition can avoid surgery, those who do need surgery generally have good outcomes.