Boutonniere Deformity (BD) is a condition characterized by a deformity
in the finger with the middle joint bent downwards and the distal end
pointed backwards. The finger joints are connected by tendons and ligaments
which allow motion. Due to tearing of the ligaments in this condition,
finger bends downwards (flexed) at the proximal interphalangeal joint
(PIP) and hyperextended (bent backwards) at the distal interphalangeal
Rheumatoid Arthritis- In this case, the inflammatory cells are released into the synovium (joint
lining) which result in the formation of the abnormal pannus tissue. This
in turn secretes substances which can damage tendons, bones and ligaments
Trauma or injury- The tendon that is attached to the middle joint of the finger gets damaged
if a bent finger is jammed or hit by an external force. This prevents
the straightening of the joint
Bruise or cut- A cut at the top of the finger can tear the underlying tendon causing deformity
Dislocations and fractures: Dislocations and fractures in the bones of the hand may also lead to
- Swelling and tenderness
- Visibly deformed finger
- Limited ability to stretch the finger
Imaging Tests: X-ray imaging helps to diagnose broken bones and soft tissue structures.
Elson’s Test: The patient is asked to straighten the injured finger to check for loss
Ice packs and heat therapy: Ice packs can be applied for 24-48 hours at regular intervals. They help
to relieve pain and swelling. Heat therapy can also be beneficial in relieving
Medications- Corticosteroids and anti-inflammatory medicines may be prescribed if
the patient is suffering from Arthritis.
Splinting- The middle part of the finger is secured using a splint for 4-6 weeks
to allow the ends of the tendon to regrow and join each other. The patient
may be asked to continue wearing the splint at night after 6 weeks
Exercises- The doctor may recommend specific stretching and strengthening exercises
to improve functionality. It may help to restore the normal range of motion.
Taping: Taping is recommended if the patient is likely to participate in sports
even after the treatment as a precautionary measure. It can help to provide
stability to the fingers.
Surgical treatment- This is required if the patient is suffering from Rheumatoid Arthritis,
the tendon is completely torn or a piece of bone gets detached along with
the tendon. The tendon and the bone are put back into their correct anatomical position.
treatment of Boutonniere Deformity, visit OrthoTexas. To schedule an appointment with the orthopedic doctors
in Flower Mound, TX you can call at(972) 899 – 4679.