In some interphalangeal joints, there is fixation of the joint with failure of flexion or extension. Recreating a new joint space may be difficult. What can be done to achieve efficient joint space and movement?
capsulotomy and collateral ligament release and other soft tissue release of the MCP and PIP joint
There is no evidence available for when conservative treatment should cease before considering operative intervention. However, it seems surgeons agree that surgery should be considered when a patient does not respond to a period of non-operative treatment. Surgeons and their patients should comprehend the following points before they decide to undergo surgery to improve the motion of a finger. First, treatment of the stiff finger must be comprehensive and operative intervention is only one of the stages in a long treatment process. The thought that the stiffness can be resolved by one surgery is not realistic. Second, although operative management can achieve improvement for stiff joints, the operation damages the structures of the finger at the same time. Therefore, a lack of preoperative evaluation, surgical technique, post-operative exercise and patient cooperation, may result in a poor outcome.
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