Swan Neck Deformity

By: Julia Guthart, OTR/L, CHT – Site Coordinator/Hand Therapy Director

Basic Anatomy of Finger

The finger is made up of three bones, or phalanges, with ligaments attached to these bones that either pulls the finger into flexion or extension.

There are three joints that compose the finger: the IP joint, the DIP joint (which makes up the fingertip) and the PIP joint (which makes up the middle knuckle).

X-ray image of the bones and joints of the hand with labels showing PIP, DIP, and MCP joints

When there is a disruption of either the joint or ligaments of the finger, deformities such as swan neck deformity can occur.

What is Swan Neck Deformity?

Swan Neck Deformity can best be described by the PIP (Proximal Interphalangeal joint) joint of the finger moving into hyperextension and the DIP (Distal Interphalangeal joint) going into a flexed position. 

image of a swan neck deformity in the middle finger with a label and arrow showing the deformity at the PIP joint

When these two movement patterns occur at the finger the end result is the joint resembling a swan’s neck – hence, where we get the term swan neck deformity. 

Typically, this can be diagnosed upon physical examination from an MD or diagnostic imaging in the form of x-rays.

How Does Swan Neck Deformity Happen?

The most common cause of swan neck deformity is Rheumatoid arthritis. RA is a chronic inflammatory disorder that affects joints throughout the body such as hands or feet. 

This condition commonly occurs when your immune system attacks your own body’s tissue. With chronic inflammation, this can cause laxity of the ligaments of your fingers resulting in an overstretch of the joint and results in hyperextension of the PIP joint and flexion of the DIP joint. 

Other causes the can contribute to swan neck deformity may be untreated mallet finger, nerve damage, finger tendon rupture or misalignment of a fracture of PIP joint from acute trauma.

Learn about the Most Common Finger Injuries Here.

Treatment Options for Swan Neck Deformity

Depending on severity of the deformity, treatment options include either conservative management (which includes physical therapy or splinting) or in more severe cases, than surgery may be required. 

Conservative management includes splinting of the finger (ring splint) to prevent hyperextension of the PIP joint and physical therapy including exercising, stretching, and massage of the hand and finger. 

If conservative methods fail to correct the deformity, then surgery could potentially be the course of treatment. 

If surgical intervention is necessary, the specific type of surgery will be determined by your physician - but this can include surgical techniques such as tendon and ligaments surrounding the PIP joints being:

  • Release
  • Realignment
  • Repair 

Other treatment options may include a PIP joint arthroplasty or a joint fusion, although these methods are less common. Following surgery, physical therapy is usually necessary to restore proper function of hand and finger.

Related Links:

Whether you are suffering from back issues, joint pain, or injuries resulting from any type of activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL who specialize in orthopedic rehab. Call (904) 858-7045. To see a JOI Orthopedic Hand Specialist, call (904)JOI-2000, Schedule online, or click the link below.



Skip to content