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Congenital flexion-adduction contracture of the first finger of the hand: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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ICD-10 code
Q74.3 Congenital flexion-adduction contracture of the first finger of the hand.
Symptoms of congenital flexion-adduction contracture of the first finger of the hand
Congenital flexion-adduction contracture of the first finger of the hand is found in the overwhelming majority of cases in patients with congenital multiple or distal type of arthrogryposis. In this case, flexion contracture in the metacarpophalangeal joint of the thumb and adduction of the first ray to the palm, deficit of soft tissues on the palmar surface of the hand in the projection of the first interdigital and intermetacarpal spaces are clinically observed.
Classification
Based on the severity of flexion and adduction contractures, the possibility of correcting the deformation, the deficit of soft tissues on the palmar surface of the first finger of the hand and the thenar region, the condition of the flexor and extensor muscles, as well as the amplitude of active extension, three degrees of deformation severity are distinguished. Congenital flexion-adduction contracture of the first finger of the hand in some cases in patients with arthrogryposis is combined with ulnar deviation of the second-fifth fingers at the level of the metacarpophalangeal joints and flexion contractures in the interphalangeal and metacarpophalangeal joints, which is due to an imbalance in the short muscles of the hand.
Treatment of congenital flexion-adduction contracture of the first finger of the hand
In cases of congenital flexion-adduction contracture of the first finger of the hand and ulnar deviation of the fingers, conservative treatment is indicated for the child already in the first months of life, including massage. Exercise therapy, thermal procedures (salt heating pads, paraffin, ozokerite), staged correction with removable splints. Early initiation of conservative therapy significantly reduces the severity of the pathology and in some cases excludes further surgical interventions. If conservative treatment is ineffective at the age of 10-12 months, surgical treatment is recommended, including combined skin grafting, as well as interventions on the tendon-muscle apparatus of the hand.
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