Intrinsic Contracture

ICD-9 Classification / Treatment
Etiology / Natural History Associated Injuries / DDx
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References


Intrinsic Contracture ICD-9


Intrinsic Contracture Etiology / Epidemiology / Natural History

  • Intrinsic tightness may occur after severe crush injury to the hand or unrecognized compartment syndrome or trauma or distal joint malalignment due to RA

Intrinsic Contracture Anatomy


Intrinsic Contracture Clinical Evaluation

  • painless hand stiffness with limited grip strength 
  • limited PIP flexion while the MP joints are fully extended, with greater PIP flexion with the MP joints flexed.
  • Bunnell test=MCP hyperextension puts intrinsics on stretch and causes decreased IP flexion with intrinsic tightness. This is due to the displacement of the lateral bands which occurs due to many reasons.
  • MCP joint flexion and IP extension resting posture.

Intrinsic Contracture Xray / Diagnositc Tests

  •  Hand films generally normal. 

Intrinsic Contracture Classification / Treatment

  • Nonoperative: passive stretching
  • Operative: distal intrinsic releases followed by supervised hand therapy

Intrinsic Contracture Associated Injuries / Differential Diagnosis

  •  CRPS

Intrinsic Contracture Complications

Intrinsic Contracture Follow-up Care


Intrinsic Contracture Review References

  • Smith RJ: Non-ischemic contractures of the intrinsic muscles of the hand. JBJS 1971;53:1313-133
  • BUNNELL S. Ischaemic contracture, local, in the hand. J Bone Joint Surg Am. 1953 Jan;35-A(1):88-101.
  • HARRIS C Jr, RIORDAN DC. Intrinsic contracture in the hand and its surgical treatment. J Bone Joint Surg Am. 1954 Jan;36-A(1):10-20.