الفهرس 
I- IntroductionOnly 14 pages are availabe for public view
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Abstract
In this prospective study, 24 patients with post-traumatic stiff metacarpophalangeal joints (76 digits) were studied prospectively, they were treated conservatively through physiotherapy and follow up, cases who did not respond to conservative treatment, operative treatment was decided. So 10 cases were operated and followed up for an average duration of 9 months (ranging from 5-14 months).
The study represented the management of 76 fingers of stiff MCP joints.
On reviewing the results of our study, the following conclusions were made:
o Prevention of MCP joint stiffness is better than treatment because restoration of pre-stiffness ROM is difficult.
o Capsulotomy is relatively simple procedure which can be used to mobilize metacarpophalangeal joints of the fingers, affording useful joints, unless there are too many other pathological changes.
The poor results of capsulotomy are due to conditions outside of the joint itself, which often can be corrected by associated surgical procedures.
o Cases with CRPS require great care and closed follow up of the patient. Adequate analgesia, anti oedematous measures and early mobilization are mandatory to get good results.
o Postoperative Mobilization as early as the patient can tolerate is the key stone of having good results. As it was noticed that patients who do not mobilize their joints early due to any cause especially pain tend to have bad results.
o Physiotherapy and non operative measures are effective with some cases and may get excellent results especially in patients of stiff MP after tendon injury and repair & patients with factures of metacarpals and phalanges.
o Pre operative physiotherapy and exercises for patients who undergo operative management of MCP stiffness to get the best ROM could be reached by the patient to facilitate and improve the postoperative ROM of the joints.
o Dorsal approach in capsulotomy is easy and give a good view of the articular surfaces of the joint and tenolysis of the extensor tendons.
o Avoidance of complete release of the sagittal band of the extensor expansion is important to avoid subluxation of the extensor tendon.
o A 2nd operative procedure can give better results if the patient is not satisfied. Then the patient is more compliant in the postoperative treatment program, the patient is psychologically prepared to accept the immediate postoperative pain.