Bilateral Fifth-Finger Camptodactyly
Camptodactyly is a permanent flexion contracture at the proximal interphalangeal joints. Most cases are limited to fifth-finger involvement; however, other fingers may also be involved.1,2 The incidence of camptodactyly is approximately 1% in the general population, and involvement is frequently bilateral. Although its inheritance is sporadic, an autosomal dominant pattern with variable penetrance and expressivity has been reported. Two types of camptodactyly have been defined: one is notable in the first year of life, and the other manifests after 10 yrs of age for reasons that remain unclear.1,2
Camptodactyly may accompany other anomalies or a number of very rare syndromes. Therefore, physicians should carefully examine patients for other musculoskeletal deformities.1 Isolated camptodactyly is not a rare condition; however, it may be overlooked if it is restricted to the fifth fingers and does not influence hand function. The condition can be mistaken for other rheumatologic disorders, including rheumatoid arthritis and Dupuytren contracture. The diagnosis of this deformity at the onset is of utmost importance because the use of splints and stretching at that time may be useful. Early identification of the condition will also prevent unnecessary diagnostic work-up and patient anxiety. If the condition is left untreated for several years, the position of permanent fixation leads to contracture in the joint.2 Surgery may be considered if conservative measures have failed.