Boutonnière Deformity of Finger(BD; Buttonhole Deformity; Central Slip Disruption; Central Slip Injury; Deformity of Finger, Boutonnière; Extensor Tendon Rupture; PIP Joint Sprain)Pronounced: boo-ten-EER de-FORM-uh-tee of finger
by
Mary Cresse DefinitionBoutonnière 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.
CausesIn 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 middle joint is forced down and the fingertip bends back. 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:
Risk Factors TOPThese factors increase your chance of developing BD:
Tell your doctor if you have any of these risk factors. Symptoms TOPIf you have any of these symptoms, do not assume it is due to BD. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
Diagnosis TOPYour doctor will ask 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. Treatment TOPTalk with your doctor about the best treatment plan for you. Treatment options include the following: MedicationYour doctor may recommend the following medications:
Nonsurgical ApproachesFor milder cases, the treatment is nonsurgical and may involve:
If your finger does not improve, you may need surgery. SurgerySurgery 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. Prevention TOPTo help reduce your chance of getting BD, take the following steps:
RESOURCES:American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/ National Institutes of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/ CANADIAN RESOURCES:Canadian Orthopaedic Foundation http://www.canorth.org/ Physical Therapy Canada http://www.physicaltherapy.ca/ References:
Boutonniere deformity of the finger. Orthogate website. Available at:
http://www.orthoga...
. Updated July 27, 2006. Accessed October 24, 2012.
Dupuytren disease. EBSCO Publishing DynaMed website. Available at:
http://www.ebscohost.com/dynamed
. Updated January 17, 2012. Accessed October 23, 2012.
Sports-related wrist and hand injuries. EBSCO Patient Education Reference Center website. Available at:
http://www.ebscohost.com/pointofcare
. Updated May 21, 2012. Accessed October 23, 2012.
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Last reviewed October 2012 by John C. Keel, MD Last Updated: 10/31/2012 | |