Proximal Interphalangeal Joint Flexion Contracture Treatment by Serial Casting Method and the Use of Thermoplastic Tape

Abstract

Flexion contractures of the Proximal Interphalangeal joint are the most frequent complications resulting from surgical procedures and traumatic events. Orthotic interventions for the treatment of contractures may include serial splinting, serial casting, dynamic or static progressive orthoses, or a combination of these orthoses. This study aimed to determine the effects of serial casting methods using thermoplastic tape in the Proximal Interphalangeal (PIP) joint flexion contracture treatment. Methods: Thirty-one patients with flexion contracture of the PIP joint (mean: 32.5°, range: 10-65°) were treated by serial casting method using thermoplastic tape. 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 requested to visit the clinic every other day for recasting and receiving exercises. Results: After 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 1.8 cm. 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: The use of thermoplastic tape for serial casting is an effective and reliable method for the treatment of PIP joint flexion contracture.