A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint

Purpose: Loss of redundant soft tissue over the proximal interphalangeal joint (PIPJ) may be a reason for the failed restoration of PIP motion. This study aimed to quantify the area of redundant skin over the PIPJ in normal subjects. Methods: Measurements of 200 healthy volunteers were obtained usin...

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Main Authors: Justine S. Kim, MD, Alexandria A. Bosetti, BS, Elizabeth M. Kenny, MD, Nia Buckner, MSc, Samantha Maliha, MD, MS, Mark E. Baratz, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Journal of Hand Surgery Global Online
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2589514125000684
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author Justine S. Kim, MD
Alexandria A. Bosetti, BS
Elizabeth M. Kenny, MD
Nia Buckner, MSc
Samantha Maliha, MD, MS
Mark E. Baratz, MD
author_facet Justine S. Kim, MD
Alexandria A. Bosetti, BS
Elizabeth M. Kenny, MD
Nia Buckner, MSc
Samantha Maliha, MD, MS
Mark E. Baratz, MD
author_sort Justine S. Kim, MD
collection DOAJ
description Purpose: Loss of redundant soft tissue over the proximal interphalangeal joint (PIPJ) may be a reason for the failed restoration of PIP motion. This study aimed to quantify the area of redundant skin over the PIPJ in normal subjects. Methods: Measurements of 200 healthy volunteers were obtained using a novel technique. Redundant skin over the PIPJ was pinched and marked in a radial-to-ulnar, then proximal-to-distal direction with the PIPJ extended. The area of skin overlying the PIPJ was calculated for the index, middle, ring, and small fingers. A standardized ratio was developed to provide a normative scale to compare post-traumatic skin redundancy. Results: The study population included 82 men and 118 women. Demographics including average height, weight, body mass index (BMI), smoking status, and hand dominance were collected. Skin redundancy or area of skin (mm2) overlying the PIPJ was calculated for bilateral index, middle, ring, and small fingers. Skin redundancy was greater in ring fingers of men compared with those of women. Skin redundancy was examined between BMI greater than 30 and less than 30 and found to be statistically different in the middle, ring, and small fingers. Normative values for skin redundancy by percentiles for each gender and BMI were generated. Conclusions: Establishment of normative values may enable surgeons to explain the lack of progress after surgical joint release, determine progress with hand therapy, and choose the optimal timing of surgical intervention once soft-tissue equilibrium is achieved. Type of study/level of evidence: Prognostic III.
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spelling doaj-art-a1e2d40fa3244754a470a16eac759e372025-08-20T02:04:38ZengElsevierJournal of Hand Surgery Global Online2589-51412025-07-017410074810.1016/j.jhsg.2025.100748A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal JointJustine S. Kim, MD0Alexandria A. Bosetti, BS1Elizabeth M. Kenny, MD2Nia Buckner, MSc3Samantha Maliha, MD, MS4Mark E. Baratz, MD5UPMC Orthopaedic Specialists, Pittsburgh, PAUPMC Orthopaedic Specialists, Pittsburgh, PA; Corresponding author: Alexandria A. Bosetti, BS, UPMC Orthopaedic Specialists, 9104 Babcock Blvd. Pittsburgh PA 15237.UPMC Orthopaedic Specialists, Pittsburgh, PAUPMC Orthopaedic Specialists, Pittsburgh, PAUPMC Orthopaedic Specialists, Pittsburgh, PAUPMC Orthopaedic Specialists, Pittsburgh, PAPurpose: Loss of redundant soft tissue over the proximal interphalangeal joint (PIPJ) may be a reason for the failed restoration of PIP motion. This study aimed to quantify the area of redundant skin over the PIPJ in normal subjects. Methods: Measurements of 200 healthy volunteers were obtained using a novel technique. Redundant skin over the PIPJ was pinched and marked in a radial-to-ulnar, then proximal-to-distal direction with the PIPJ extended. The area of skin overlying the PIPJ was calculated for the index, middle, ring, and small fingers. A standardized ratio was developed to provide a normative scale to compare post-traumatic skin redundancy. Results: The study population included 82 men and 118 women. Demographics including average height, weight, body mass index (BMI), smoking status, and hand dominance were collected. Skin redundancy or area of skin (mm2) overlying the PIPJ was calculated for bilateral index, middle, ring, and small fingers. Skin redundancy was greater in ring fingers of men compared with those of women. Skin redundancy was examined between BMI greater than 30 and less than 30 and found to be statistically different in the middle, ring, and small fingers. Normative values for skin redundancy by percentiles for each gender and BMI were generated. Conclusions: Establishment of normative values may enable surgeons to explain the lack of progress after surgical joint release, determine progress with hand therapy, and choose the optimal timing of surgical intervention once soft-tissue equilibrium is achieved. Type of study/level of evidence: Prognostic III.http://www.sciencedirect.com/science/article/pii/S2589514125000684ContractureProximal interphalangeal jointReconstructionRedundancySoft tissue
spellingShingle Justine S. Kim, MD
Alexandria A. Bosetti, BS
Elizabeth M. Kenny, MD
Nia Buckner, MSc
Samantha Maliha, MD, MS
Mark E. Baratz, MD
A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
Journal of Hand Surgery Global Online
Contracture
Proximal interphalangeal joint
Reconstruction
Redundancy
Soft tissue
title A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
title_full A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
title_fullStr A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
title_full_unstemmed A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
title_short A Novel Technique to Assess Soft-Tissue Redundancy Over the Proximal Interphalangeal Joint
title_sort novel technique to assess soft tissue redundancy over the proximal interphalangeal joint
topic Contracture
Proximal interphalangeal joint
Reconstruction
Redundancy
Soft tissue
url http://www.sciencedirect.com/science/article/pii/S2589514125000684
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