A new treatment algorithmic for congenital contracture of the ulnar digits-based on pathological classification.

Objective: To explore a new algorithmic treatment for Congenital Contracture of the Ulnar Digits based on pathological classification. Methods: A retrospective analysis was performed on 7 patients with Congenital contracture of the ulnar digits who were admitted and treated from 2019 to 2024, and their clinical characteristics were summarized. During the final follow-up visit, the patients' finger joint range of motion and flexor digitorum profundus muscle strength were evaluated. Hand function was assessed utilizing the hand function rating criteria established by Wang et al., while the patients' overall satisfaction was surveyed. Results: All 7 patients completed the scheduled follow-up, with durations ranging from 6 to 74 months and a mean of 26 months. All patients achieved primary wound healing, and no adverse events or complications were documented. At the final follow-up visit, with their wrists maintained in a neutral position, all patients exhibited active extension of the affected fingers to 0° without residual tension, while all digits demonstrated unimpeded flexion. Muscle strength assessment of the flexor digitorum profundus revealed that 5 patients attained Grade 5, with the remaining 2 patients rated at Grade 4. Furthermore, hand function evaluation yielded the following findings: 5 cases were categorized as "excellent" and 2 as "good," resulting in an excellent-to-good rate of 100 %. All patients expressed satisfaction with both the functional recovery of their hands and the cosmetic outcome. Conclusion: Congenital contracture of the ulnar digits can be classified into three pathological subtypes-osteophyte subtype, fibrosis subtype and mixed subtype-through the combination of clinical evaluation and surgical exploration. By adopting different treatment algorithms for different pathological subtypes and providing professional rehabilitation therapy, patients can achieve favorable therapeutic outcomes. Evidence level: Level IV.