Boutonnière deformity (BD) prevents you from straightening your finger. The disorder affects the finger’s system of tendons. The tendons allow you to flex and straighten your finger.
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In BD, the tendon on the top of the finger (called the central slip) is torn or cut from the other tendons. This creates a tear that resembles a buttonhole (or boutonnière in French). The first finger joint is forced down and the fingertip bends back at the second joint. The tendons on this part of the finger are flat and thin. They are prone to injury. If you have BD in the thumb, it affects a joint called the metacarpophalangeal (MCP).
BD can be caused by:
Factors that may increase your risk of developing BD include:
Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done, paying close attention to:
An x-ray may be done to see if you have a fracture.
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor may recommend the following medications:
For milder cases, the treatment is nonsurgical and may involve:
If your finger does not improve, you may need surgery.
Surgery is needed in severe cases. For example, when the tendon is cut or when the deformity has lasted a long time. Surgery generally does not return your finger to the way it was working before the injury. But, you may have some improvement. After surgery, you will have to do exercises to strengthen the finger.
To help reduce your chance of getting BD:
National Institutes of Arthritis and Musculoskeletal and Skin Diseases
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
Canadian Physiotherapy Association
Boutonniere deformity of the finger. Orthogate website. Available at: http://www.orthogate.org/patient-education/hand/boutonniere-deformity-of-the-finger.html. Updated July 27, 2006. Accessed August 10, 2015.
Dupuytren disease. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114104/Dupuytren-disease. Updated April 19, 2016. Accessed September 29, 2016.
To P, Watson JT. Boutonniere deformity. J Hand Surg Am. 2011 Jan; 36(1):139-42.
Last reviewed September 2016 by Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 8/10/2015