Intrinsic tightness Discussion

Intrinsic tightness may follow any inflammatory or spastic problem affecting the hand. The intrinsic muscles are deep in the palm of the hand, and are involved with complex motions of the fingers. The severity of the problem may be graded by measuring passive flexion of the proximal interphalangeal joint with the metacarpophalangeal joint held hyperextended:

Mild: PIP flexion 60 to 80 degrees

Moderate: PIP flexion 20 to 59 degrees

Severe: PIP flexion less than 20 degrees or MCP flexion contracture

Abnormalities of these muscles may cause an ill defined pain, weakness, stiffness, or any combination. Treatment options depend on whether the problem is thought to involve reversible inflammation, fibrosis or fixed contracture. Most early cases respond well to specific intrinsic stretching exercises. Refractory cases may require surgical release or lengthening.

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