BOUTONNIERE DEFORMITY

If you suffer from a boutonniere deformity, or finger pain associated with the deformity, please Schedule an appointment with one of our orthopedic specialists as soon as possible.

What is a Boutonniere Deformity?

An injury that causes damage to the tendons that straighten the middle joint of a finger results in a condition known as a Boutonnière Deformity. This results in an inability to straighten the middle joint of the injured finger while the fingertip simultaneously bends back on its own. Unless treated quickly, the injury may cause the deformity to progress further to the point of permanence and impaired function.

Boutonnière Deformity mostly occurs from an impact to the top-middle side of a flexed finger joint.

Deep cuts on the top side of the finger can also sever the central tendon from where it attaches to the bone. The name comes from the appearance of the tear in the tendon, as it looks like a buttonhole or “boutonnière” in French. In rare cases, the bone may pop out through the opening.

Causes of Boutonniere Deformity

Boutonniere deformity develops primarily due to injuries or conditions affecting the tendons and joints of the fingers. Particularly, the middle joint (proximal interphalangeal joint or PIP joint). Trauma, such as a forceful blow or crushing injury to the finger, can damage the extensor tendon over the PIP joint. Inadvertantly, causing it to tear or stretch and pull away from its bone attachment. Inflammatory conditions like rheumatoid arthritis can also weaken tendons and ligaments in the finger joints over time, leading to chronic inflammation and contributing to boutonniere deformity. Additionally, lacerations or puncture wounds that damage the extensor tendon or joint structures of the finger can result in this deformity if not properly treated.

These factors disrupt the normal alignment and function of the finger joints, resulting in the characteristic flexion at the PIP joint and extension at the fingertip seen in boutonniere deformity. Timely diagnosis and appropriate treatment are crucial to prevent permanent finger deformity and restore optimal hand function.

Boutonniere Deformity Treatment 

Boutonniere deformity treatment typically involves both non-surgical and surgical approaches, depending on the severity and underlying cause of the condition. Non-surgical treatment options focus on immobilizing the affected finger joint with splinting or casting to allow the damaged tendons to heal properly. This approach aims to correct the deformity and restore normal finger function.

In cases where non-surgical methods are insufficient or if the deformity is severe, surgical intervention may be necessary. Surgical procedures for boutonniere deformity often involve repairing or reconstructing the damaged extensor tendon to restore its function and alignment. Surgeons may also address any associated joint instability or stiffness during the procedure.

Post-operative rehabilitation plays a crucial role in recovery, involving physical therapy to regain range of motion, strengthen muscles, and improve overall hand function. The goal of treatment is to alleviate pain, correct the deformity, and optimize finger function to enable patients to resume their normal activities with minimal limitations.

Boutonniere Deformity Recovery

Recovery from boutonniere deformity depends on the severity of the condition and the chosen treatment approach. For cases treated conservatively with splinting or casting, recovery focuses on immobilizing the affected finger joint to allow the damaged extensor tendon to heal. During this period, patients typically need to follow strict immobilization protocols to ensure the tendon heals in the corrected position. Gradually, as healing progresses, physical therapy plays a crucial role in rehabilitation. Therapists prescribe exercises aimed at restoring range of motion, strengthening the affected muscles, and improving hand function.

In cases where surgical intervention is required, recovery involves a more intensive rehabilitation process. Post-operative care includes monitoring for complications, such as infection or stiffness, and adhering to a structured physical therapy regimen. Therapy sessions aim to regain full finger mobility and strength while ensuring the repaired tendon heals properly. The duration of recovery varies depending on individual factors like overall health, compliance with rehabilitation protocols, and the extent of tendon damage, with most patients achieving improved finger function and reduced deformity over time.

If you would like to speak to an Orthopedic Hand and Wrist Specialist in North Texas, give us a call at 817-697-4038, or contact us over the web. Tele-medicine appointments are also available.