Outcome review on the percutaneous release of the proximal interphalangeal joint accessory collateral ligaments

The percutaneous release of accessory collateral ligaments was introduced in 1986 as a safe and quick procedure to be attempted before open, more extensive joint release in the treatment of proximal interphalangeal joint flexion contracture. Our study analyzed the long-term results and patient satisfaction following a percutaneous release in 30 joints after a mean follow-up period of 34 months. In one half of cases the preoperative joint flexion deformity was reduced from 78 degrees to 34 degrees. The best results were observed in patients with osteoarthritis and stiff, immobilized joints. In patients with inflammatory arthritides, marked intraoperative correction was maintained rarely, joint contractures recurred early, and patients were unsatisfied. There were no intraoperative complications. Percutaneous release of the accessory collateral ligaments can produce a long lasting correction of the joint contracture, but careful patient selection and strict postoperative rehabilitation are essential for favorable outcome.