Boutonnière Deformity: Symptoms, Causes, Treatment

What are the symptoms of Boutonnière deformity?

Boutonnière deformity is a condition that affects the fingers, specifically the middle joint of the finger (proximal interphalangeal joint or PIP joint). It is characterized by specific symptoms that include:

1. Flexion deformity: The main symptom of Boutonnière deformity is the flexion or bending of the PIP joint, while the outermost joint (distal interphalangeal joint or DIP joint) and the joint closest to the hand (metacarpophalangeal joint or MCP joint) remain straight.
2. Inability to straighten the finger: Individuals with Boutonnière deformity typically have difficulty or are unable to straighten the affected finger at the PIP joint.
3. Swelling and pain: The affected finger may be swollen, and there may be pain, especially when trying to straighten the finger.
4. Decreased range of motion: There is a limited range of motion at the PIP joint, which can affect the ability to perform activities that require bending or straightening the finger.
5. Visible deformity: In severe cases, the deformity may be visibly noticeable, with the affected finger appearing bent or crooked at the PIP joint.
6. Difficulty gripping or grasping: The deformity can affect the ability to grip or grasp objects due to the altered position of the finger.

Boutonnière deformity is often caused by an injury to the extensor tendon of the finger, which can occur from a forceful blow to the finger or from a laceration. It can also be caused by conditions such as rheumatoid arthritis or other inflammatory conditions that affect the joints. Treatment for Boutonnière deformity may include splinting, physical therapy, or surgery, depending on the severity of the deformity and the underlying cause.

What are the causes of Boutonnière deformity?

Boutonnière deformity is typically caused by an injury to the extensor tendon of the finger, which can occur due to a variety of reasons. Some common causes of Boutonnière deformity include:

1. Blunt trauma: A forceful blow to the finger, such as during a fall or while playing sports, can injure the extensor tendon and lead to Boutonnière deformity.
2. Laceration: A deep cut or laceration to the back of the finger can damage the extensor tendon and result in Boutonnière deformity.
3. Rheumatoid arthritis: Chronic inflammation of the joints, such as in rheumatoid arthritis, can weaken the extensor tendon and lead to deformities like Boutonnière deformity.
4. Other inflammatory conditions: Other inflammatory conditions, such as lupus or psoriatic arthritis, can also contribute to the development of Boutonnière deformity.
5. Repetitive strain: Activities that involve repetitive bending or straightening of the fingers, such as typing or playing musical instruments, can put strain on the extensor tendon and increase the risk of injury.
6. Congenital factors: In some cases, Boutonnière deformity may be present at birth or develop during childhood due to abnormal tendon development or other congenital factors.
7. Degenerative changes: Age-related degenerative changes in the joints and tendons can weaken the extensor tendon and contribute to the development of Boutonnière deformity.

Treatment for Boutonnière deformity depends on the underlying cause and severity of the deformity. In mild cases, splinting and physical therapy may be sufficient to correct the deformity. In more severe cases, surgery may be required to repair the extensor tendon and restore normal finger function.

What is the treatment for Boutonnière deformity?

The treatment for Boutonnière deformity depends on the severity of the deformity and the underlying cause. Treatment options may include:

1. Splinting: In mild cases, wearing a splint to keep the affected finger straight can help correct the deformity. The splint is typically worn for several weeks to allow the tendon to heal properly.
2. Physical therapy: Exercises to strengthen the muscles and improve the range of motion of the affected finger may be recommended. Physical therapy can help restore normal function to the finger.
3. Steroid injections: In some cases, corticosteroid injections may be used to reduce inflammation and pain in the affected joint.
4. Surgery: If conservative measures are not effective, or if the deformity is severe, surgery may be necessary. Surgery for Boutonnière deformity typically involves repairing the damaged tendon and restoring normal alignment of the finger joints.
5. Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help reduce pain and inflammation in the affected finger.

It’s important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan for Boutonnière deformity. Untreated or improperly treated Boutonnière deformity can lead to chronic pain, stiffness, and loss of function in the affected finger.