Precision Plastic and Hand Surgery

Boutonniere Deformity

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Boutonniere Deformity is a hand condition that can cause pain and stiffness in the fingers, as well as impair mobility. The condition is caused when the middle joint on the finger bends backward uncontrollably, whereas the proximal interphalangeal joint (closest to the palm) becomes flexed and stiff. This condition usually affects at least one of the fingers and is often seen in individuals suffering from rheumatoid arthritis. Symptoms of Boutonniere Deformity may include an inability to straighten out the affected finger, as well as pain and tenderness in the metacarpophalangeal joint while attempting to do so. Treatment options may involve splinting of the affected finger and physical therapy exercises, although it is important to seek surgical intervention if needed.

Causes of Boutonniere Deformity

A Boutonniere deformity can happen for several reasons. It can happen from a cut of the tendon on the back of the finger or the thumb. It can also be due to the tearing or weakening of the same tendon due to an injury or from a disease like rheumatoid arthritis.
This results in the bent position of the joint. This bent position causes the small tendons on the side of the finger to slide toward the palm side. This worsens the bent position of the finger’s middle joint. There can then be more pull on the end joint of the finger. This causes the small joint to bend further back.

Boutonniere Deformity
  • Signs and Symptoms

    A cut of the tendon on the back of the middle joint will result in difficulty straightening that joint. The change in position of the end joint may not be seen initially but usually happens over time. The deformity may become worse over time if not treated. If the deformed position is not treated, it can result in stiffness. This can become permanent if you do not seek treatment.

  • Treatment

    There are many treatments for a Boutonniere deformity. Splinting can be used, particularly if it is started soon after the tendon is injured. Splinting alone may not give a good result in a case where the deformity is caused by rheumatoid arthritis. Multiple different surgical options have been used to treat this problem.
    In the case of a cut tendon, the best results are generally seen when the tendon is repaired early. Even with surgery, a normal position of the joints is commonly not seen.
    Your treatment plan will vary, depending on your situation. Please contact Precision Plastic and Hand Surgery in Golden to determine the best option for you.

Information obtained from: ASSH

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