Arch Hand Microsurg.  2023 Dec;28(4):239-249. 10.12790/ahm.23.0033.

A novel finger brace for preventing finger stiffness after trauma or surgery: a preliminary report with a case series

• Kim DG
• Park HJ

• KMID: 2548595
• DOI: http://doi.org/10.12790/ahm.23.0033

Abstract

Purpose
Finger stiffness is a common complication following hand trauma or surgery. Early finger range-of-motion (ROM) exercises have proven to be the most effective method for preventing finger stiffness. In this paper, we introduce a novel finger brace designed for safe and early active exercises and present preliminary results from a small case series.
Methods
Our innovative brace is designed for direct insertion into the finger, ensuring enhanced comfort during use. This brace features hinges that facilitate unrestricted movement in the proximal and distal interphalangeal joints, with each phalangeal component having a rounded shape to prevent rotation. Furthermore, grooves are integrated at the top of the phalangeal components for inserting bars; a straight bar to immobilize and a silicone band to provide elastic resistance exercises within a limited range.
Results
Among 26 patients, 17 presented with fractures, five had extensor tendon injuries, and three had dislocations. For patients not requiring surgery, we applied the brace as early as possible. In cases involving surgery, the brace was applied step by step. When fixation was necessary for the first time, a straight bar was applied, and when starting finger movement, a silicone band was applied. The silicone band was then released to allow free finger movement. Except for one patient necessitating extensor tendon reconstruction due to a neglected rupture, all patients achieved full ROM without any complications.
Conclusion
Our novel ROM finger brace represents a safe and user-friendly option for effectively initiating finger ROM exercises.

Keyword

Fingers; Injuries; Stiffness; Braces; Range-of-motion

Figure

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  Fig. 1. The appearance of the finger brace. (A) Extension state. (B) Flexion state.

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  Fig. 2. The range of motion of the brace is 0° to 90° for both the proximal and distal interphalangeal joints. (A) Extension state. (B) Flexion state.

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  Fig. 3. Because the thumb has different anatomical features from other fingers, we made a separate brace just for the thumb. One hinge is used for the thumb, and two hinges are used for the other finger. (A) Comparison from above. (B) Comparison from the side.

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  Fig. 4. Eight sizes were prepared for each 5-mm length so that an appropriate option could be chosen according to the finger size.

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  Fig. 5. The brace box is printed with a picture of the actual size of the brace, so it is possible to check for a proper brace size that fits the length of one’s finger without wearing it. (A) Appropriate brace size for finger length. (B) Longer brace size than finger length.

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  Fig. 6. Two kinds of bars. (A) Straight bar: blocking the movement. (B) Wearing a straight bar on the finger brace body. (C) Silicone band allowing elastic resistance-based range-of-motion exercises. (D) Wearing a silicone band on the finger brace body.

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  Fig. 7. (A) Immediate radiograph showing a right second distal phalanx open fracture with displacement. (B) Plain X-ray after Kirschner wire (K-wire) fixation. (C) The K-wire was removed at 3 weeks after surgery, and the fracture fragment was well reduced. (D) Photo of the patient wearing the finger brace without a silicone band: Working out for full flexion.

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  Fig. 8. (A) Clinical photo of a 57-year-old female patient wearing the finger brace with a silicone band applied. (B) Clinical photo of the patient wearing the finger brace without a silicone band. (C) Clinical photo of a 65-year-old male patient wearing the finger brace with a silicone band applied.

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  Fig. 9. (A) Immediate radiograph revealing a right second proximal phalanx fracture with slight displacement. (B) After 3 months of treatment, an X-ray examination confirmed that all fractures were fused. (C) Clinical photo of a 65-year-old male patient wearing the finger brace with a silicone band applied. (D) Clinical photo of the patient wearing the finger brace without a silicone band: full flexion available.

Reference

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