Boutonniere Deformity

Boutonniere deformity is a condition in which the finger's middle joint sticks in a bent position and the joint at the tip of the finger hyperextends. A boutonniere deformity can also occur in toes.

What You Need to Know About Boutonniere Deformity

What is Boutonniere Deformity?

Boutonniere Deformity is a condition in which the finger sticks in a bent position, causing the joint at the finger's tip to extend upward. The condition occurs when the tendon that straightens the fingers — or toes — is torn. When the tendon tears, a slit appears that looks like a buttonhole or boutonniere in French, and the finger cannot straighten.

Failure to quickly treat the condition may result in permanent damage and decreased functioning.

Finding the best boutonniere deformity treatments starts with a visit to Resurgens Orthopaedics. Schedule an appointment at one of our Metro Atlanta locations now!

What Causes Boutonniere Deformity?

Injury to the extensor tendon can result in boutonniere deformity. The extensor tendon, also called the central slip, extends from the back of the finger to the PIP joint, the finger's middle joint.

Boutonniere deformity can occur when:

  • The extended finger is forcefully bent

  • The finger joint dislocates toward the palm

  • An object lacerates the finger

  • A disease such as rheumatoid arthritis or osteoarthritis worsens

If an injury to the extensor tendon goes untreated, the lateral bands stabilizing the tendon can weaken and create an imbalance between the PIP and DIP joints. It's also possible for this condition to be present at birth.

Boutonniere Deformity Symptoms

The most common boutonniere deformity symptoms include:

  • Swelling in the finger's middle — or PIP — joint

  • Pain the finger

  • Inability to straighten your finger

  • Hyperextension of the finger's tip — or DIP — joint

  • The joint's stiffness worsens

If you are experiencing boutonniere deformity symptoms in your thumb, the finger may be bent at the first joint.

How is Boutonniere Deformity Diagnosed?

During your visit to Resurgens Orthopaedics, a Physician will review your medical history and gather information from you about the injury. To test the central slip's intactness, your physician will examine your finger's middle joint while you try to extend your finger.

Your doctor may also ask for diagnostic testing to visualize the full scope of your boutonniere deformity. This technology helps us create your customized treatment plan.

Boutonniere Deformity Treatment

The nature of the injury will help determine the best form of treatment. Some boutonniere deformity treatments may require a splint and physical therapy, while others may require surgery, including severe lacerations and chronic cases.

Non-Surgical Treatment

If the tendon injury is treated quickly, splinting the PIP joint for four to six weeks may resolve the issue. Some exercises may help increase strength and mobility. Protecting the joint from contact will also prevent future injury.

Your doctor may also prescribe disease-modifying anti-rheumatic drugs, biologic response modifiers, and other medications if rheumatoid arthritis causes the condition.

Surgical Treatment

While your doctor will explore non-surgical treatment options first, surgery may be the best plan if the condition does not improve or worsens. In severe cases, such as a laceration, a surgeon may need to reattach the tendon.

A boutonniere deformity can happen to anyone at any time. Treating the condition is essential to prevent long-term damage. If you experience any Boutonniere deformity symptoms, you should schedule your appointment with the Hand & Wrist specialists at Resurgens Orthopaedics today.

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