(See also Overview and Evaluation of Hand Disorders Overview and Evaluation of Hand Disorders Common hand disorders include a variety of deformities, ganglia, infections, Kienböck disease, nerve compression syndromes, noninfectious tenosynovitis, and osteoarthritis. (See also complex... read more .)
Boutonnière deformity can result from tendon laceration, dislocation, fracture, osteoarthritis Osteoarthritis (OA) Osteoarthritis is a chronic arthropathy characterized by disruption and potential loss of joint cartilage along with other joint changes, including bone hypertrophy (osteophyte formation). Symptoms... read more , or rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily involves the joints. RA causes damage mediated by cytokines, chemokines, and metalloproteases. Characteristically... read more . Classically, the deformity is caused by disruption of the central slip attachment of the extensor tendon to the base of the middle phalanx, allowing the proximal phalanx to protrude (“buttonhole”) between the lateral bands of the extensor tendon.
Initial treatment of boutonnière deformity consists of splinting, but it must occur before scarring and fixed deformities develop. Surgical reconstruction often cannot restore normal motion but may decrease the deformity and improve hand function.
Boutonnière and Swan-Neck Deformity