PIP Joint Stiffness

July 2020

This gentleman in his mid-50s had his index finger crushed at work about 3 months ago, resulting in a fracture of the proximal phalanx plus lots of soft tissue injury, swelling and scar tissue. The fracture was stabilised surgically with a small plate, and healed well.

Unfortunately, the PIP joint (the middle joint of the finger) became very stiff during the fracture healing time. We tried exercises, stretches, and all sorts of other physio strategies but we just couldn't make progress - the knuckle refused to bend more or straighten more!

The pictures show a single splint which we are hoping to use for both problems. It is a static-progressive splint, meaning that the patient can adjust it himself to provide gentle tension, and can loosen it if it is becoming painful. We have built two different outriggers onto the splint base, and each outrigger has a plastic sling attached with fishing line. In the first picture you can see his PIP join being held up in a straight position, and in the second picture it is being held in a bent position. It was quite a fun splint to make!

Splinting will not be enough to fix this problem by itself. He will need to continue doing regular exercises at home and hands-on physiotherapy for several weeks to come. Some previous patients with similar problems have required further surgery to release tendons or joints that are too stuck down by aggressive scar tissue. But hopefully the splint will be a useful tool for him to get that stiff PIP joint moving again, in both directions.