1999, Number 4
An Med Asoc Med Hosp ABC 1999; 44 (4)
Fernández VJM, Juárez RCS, Schenk PJ
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ABSTRACTThe swan neck deformity is characterized by proximal interphalangeal joint (PIP) hyperextension and distal interphalangeal joint (DIP) flexion. Patients have functional impairment and it is progressive. From 1971 to 1999 in the ABC Hospital, 33 patients: 29 female and 4 male, with 48 finger deformities were studied. According to Nalebuff and Millender classification were 5 cases type I, twelve type II, 13 type III, eleven type IV and seven type V. Flexor synovectomy and volar plasty was performed in 2 cases with type II deformity, and failed by recurrence. Four fingers with type III deformity were treated by arthroplasty resection of the metacarpophalangeal joint with intrinsic cubital release without improvement. In type IV and V we performed 16 PIP fusion, all with improvement in grasp. Just one case of superficial infection was recorded. The rheumatologist must know this classification in order to determine the type of deformity, and refer early to hand surgeons in order to soft tissue procedures. When the deformity is advanced PIP fusion is a definitive procedure that improves the patients quality of life.