Boutonniere Deformity

Boutonnière deformity is a hand deformity that involves the abnormal positioning of the fingers, specifically the middle joint of the finger (proximal interphalangeal joint or PIP joint) and the fingertip joint (distal interphalangeal joint or DIP joint). In this condition, the PIP joint becomes bent in the direction of the palm, while the DIP joint hyperextends, causing the finger to resemble the shape of a “buttonhole” or “boutonnière,” which is a type of ornamental buttonhole found on clothing.

Boutonnière deformity is often caused by an injury to the tendons that control the finger’s movement. It can result from trauma, such as a forceful impact to the finger, or from medical conditions that affect the tendons, such as rheumatoid arthritis.

Symptoms of boutonnière deformity include:

• Inability to fully straighten the PIP joint, resulting in a bent position.
• Hyperextension of the DIP joint, causing the fingertip to be pushed backward.
• Pain and tenderness at the affected joint.
• Swelling and stiffness in the finger.

Diagnosis is usually based on physical examination and medical history, along with X-rays to assess the extent of the deformity and to rule out any associated fractures.

Treatment for boutonnière deformity depends on the severity of the condition:

• Conservative Treatment: Mild cases might be managed with splinting. A specially designed splint can help keep the PIP joint in an extended position, allowing the damaged tendons to heal. This treatment is most effective when started early.
• Surgery: Severe cases or cases that don’t respond to conservative treatments might require surgical intervention. Surgery aims to repair or reconstruct the damaged tendons and realign the joints.
• Rehabilitation: After treatment, rehabilitation exercises guided by a healthcare professional can help restore finger strength and flexibility.

Early intervention is important for the best outcomes in treating boutonnière deformity. If you suspect you have this condition or notice any changes in your finger’s appearance or function, it’s advisable to consult a medical professional for an accurate diagnosis and appropriate treatment recommendations.