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Boutonnière Deformity

Finger deformity with PIP joint flexion and DIP joint hyperextension after extensor central slip injury.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Boutonnière Deformity?

Boutonnière deformity is a finger deformity in which the proximal interphalangeal joint is held in flexion and the distal interphalangeal joint in hyperextension, due to disruption of the central slip of the extensor tendon and volar migration of the lateral bands.

Common causes include trauma to a flexed finger, laceration over the dorsal PIP joint and chronic synovitis in rheumatoid arthritis.

Early recognition and treatment are essential to prevent fixed deformity and functional impairment of the hand.

Symptoms

Inability to actively extend the PIP joint
PIP joint held in flexion
DIP joint hyperextended
Pain and swelling over the dorsal PIP joint
Tenderness over the central slip insertion
Difficulty grasping and pinching
Progressive deformity if untreated

Risk Factors

Forceful flexion injury of the finger
Laceration over the dorsal PIP joint
Sports involving ball impact on fingers
Rheumatoid arthritis with chronic PIP synovitis
Burns of the hand
Late presentation of acute injury
Inadequate splinting after central slip injury

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New inability to straighten the PIP joint
  • Persistent pain and swelling over the PIP
  • Progressive deformity
  • Open wound over the dorsum of the PIP
  • Suspected tendon injury after sports
  • Lack of improvement after splinting
  • Functional limitation in daily activities

Treatment Methods

01
Detailed clinical examination and radiographs
02
PIP joint extension splinting for several weeks in acute injury
03
Hand therapy with progressive motion exercises
04
Surgical repair of the central slip in displaced or open injuries
05
Treatment of underlying rheumatoid synovitis
06
Tendon reconstruction in chronic deformity
07
Long-term follow-up to prevent recurrence

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ortopedi ve Travmatoloji Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.