Boutonniere Deformity
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What is Boutonniere Deformity?
Boutonniere deformity is a condition in which the proximal interphalangeal (PIP) joint of a finger is flexed (bent) and the distal interphalangeal (DIP) joint is hyperextended. This results when there is an injury to the extensor tendon at the PIP joint of the finger. This causes the lateral bands to pull the PIP joint into flexion.
Where does Boutonniere Deformity Occur at on the Body?
The condition of boutonniere deformity occurs in the joint of the finger. This hyperextension of the finger joint can result in swelling and pain of the middle joint of the finger. A Boutonniere deformity is a fairly common condition but it can also be cause by wear and tear over time. It can also be a sign of arthritis in the finger joint.
Boutonniere Deformity
What Causes Boutonniere Deformity?
There are several different injuries that can lead to a Boutonniere deformity. One being a laceration to the central slip of the extensor tendon at the top of the PIP joint. Secondly, a blow to the top of the PIP joint when it is bent can cause a rupture to this tendon as well. Jamming the finger when playing sports, such as football or basketball, can also lead to a Boutonniere deformity. All these injuries cause a disruption to the extensor mechanism of a finger’s PIP joint. This in turn causes the lateral bands on both sides of the joint to pull it down into flexion (see image below).
Other causes, although more rare, include burns, rheumatoid arthritis, and birth defects.
Middle Joint of the Finger is Where Boutonniere Deformity Occurs.
How is Boutonniere Deformity Treated?
The treatment of Boutonniere deformity will typically begin with nonsurgical intervention, including splinting. The splint will maintain the PIP joint into extension to allow for the central slip of the extensor tendon to heal back to the bone. The splint is typically worn continuously for up to 6 weeks. After the initial splinting phase, occupational therapy may be prescribed for regaining range of motion and strength of the finger and hand. The deformity may become worse over time if it is left without treatment.
However, if the central slip is severed, surgical intervention may be indicated to repair it. With splinting and occupational therapy being prescribed following the initial post-operative phase.
Finger Injuries
The Boutonniere deformity is just one of many injuries which occur to your fingers. It is so important to be properly evaluated by an orthopedic physician who specializes in these injuries. Each of the injuries to the finger are splinted differently to allow for proper healing.
Finger sprains are treated differently than finger fractures. It is so important to get an x-ray and a proper evaluation from an orthopedic physician. Our JOI physicians work very closely with our Certified Hand Therapists to make sure you receive the proper splint and treatment. This team approach can certainly improve your outcome from a finger injury. We are here to help you to get back to the activities that you love.
Related Articles:
- What are the Finger Bones Called?
- Understanding the Different Parts of the Finger
- Jammed Finger Treatment and Healing Time
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