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Swan Neck Deformity Explained

  
  
  

What is a Swan Neck deformity?
A Swan Neck deformity is a condition where the middle joint of the finger, known as the PIP joint, hyperextends or bends backwards and the end joint near the fingernail, known as the DIP joint, flexes or is bent downwards.

Swan Neck Deformity picture showing hyperextended PIP and flexed DIP joint

How do you get a Swan Neck deformity?
The most common causes of a Swan Neck deformity are a diagnosis of Rheumatoid Arthritis (RA), a ligament injury or an untreated Mallet or "Baseball" finger. Swan Neck deformity can also be a problem for people with a connective tissue disease known as Ehlers-Danlos Syndrome (EDS).

There is a thick ligament called the volar plate under the middle finger joint that keeps it from bending backwards. This ligament can be damaged by the inflammation common in Rheumatoid Arthritis and it can be torn when the finger is forcefully hyperextended. In addition to the volar plate, the tendons that act on the middle and end joint can be damaged or displaced by arthritis and by injuries such as Mallet finger injury or hyperextension.

Some people are born with loose or lax joints that are often misnamed "double jointed". This laxity allows the fingers to bend backwards without there being any injury and without it being a problem. But for persons with Ehlers-Danlos Syndrome, the fingers can hyperextend so much that it's difficult to bend the fingers.

How is a Swan Neck deformity treated?
Splinting the finger to stop the hyperextension is often all that is needed and can be a very successful long term solution. In more severe cases, surgery can be done to help realign the tendons and tighten the tissues around the joint.

What kind of splint options are there?
There are splints on the market designed to treat Swan Neck deformity. There are some different metal splints available, one made out of stainless steel and one made from silver. Because the steel splints can be hard to wear and the silver splints can be expensive, I designed a lightweight plastic splint called the Oval-8 Finger Splint.

Oval-8 splints are designed to prevent hyperextension at the PIP joint but allow the finger to bend. They come in a broad range of sizes so they will fit almost any hand and are thin enough to be worn on several fingers at the same time if necessary. The wide bands make them comfortable to wear and depending on skin color, they can almost disappear on your finger. Oval-8's are comfortable, cost effective and can be worn short term or permanently if needed.

describe the image
                                                 (Oval-8 Finger Splint)

How do I get an Oval-8 splint?
Oval-8 splints have to be sized and fitted by a health care provider to make certain the fit is correct and that you know how to care for your finger.

If your doctor or therapist does not know about Oval-8 splints, you and they can get more information by visiting the Oval-8 page. It includes a video that shows how the Oval-8 is fit for a Swan Neck deformity.

You can even look for a hand surgeon or hand therapist near you who might have the Oval-8's and will be able to fit you by going to the "About Us" page. There are links for finding hand therapists or orthopedic doctors at the bottom of that page.

Author: Julie Belkin


Comments

I went to a doctor, i was diagnose with swarm neck deformity on both hands the pinkie finger, but since I'm 38 he told i had to live with it, I wanted surgery. I just recently went back to school, and since i was a kid my family and other kids tease me about my fingers . This made me shy and front of other people so I started to close my hands when i was around people. If i cant get surgery , Can i atlease wear a splint, I would like to have some normacy of my life go with my friends to get my nails done ect. So do I have to have a doctors order? Please give me some advice. Because I'm at the end of my ropes.
Posted @ Wednesday, March 10, 2010 9:16 AM by valerie buckner
Hello Valerie, 
 
There are splint options available for Swan Neck Deformity, including the Oval-8 splints shown in the above blog and Silver Ring Splints, which are offered by a different company. If your doctor is not familiar with these splints, you could print the blog article above and ask if the doctor thinks the Oval-8 splints are right for you.  
 
Regardless of whether you decide to use an Oval-8 splint or a Silver Ring Splint, you would need to be fitted by a health care provider who has a sizing set to ensure the splint fits correctly. If your doctor doesn’t have a sizing set or an Oval-8 kit, he/she can purchase one from us. Your doctor may also refer you to a Certified Hand Therapist (= CHT) for further evaluation.  
Posted @ Thursday, March 18, 2010 1:16 PM by Heike at 3-Point Products
I have a boutonniere deformity (have had for over 30 years). I can straighten the PIP joint and DIP joint passively and if I just put the finger on the table. I am having more of a concern with the DIP hyperextension. The PIP is flexd OK but the DIP looks like a severe double joint. I have tried splinting but all of the splits focus on straightening the PIP (which isn't even a problem) but they all leave my DIP and fingertip sticking up like I am giving the bird (second finger). I have tried taping the tip down to look like a mallet finger since the DIP joint is where I feel almost all of the pain and tightness (like when I try to flex the joint downward). It is so tight. 
 
 
 
What splint should I try in order to work on the DIP side of the boutonniere deformity? I am desperate for some ideas and eveeything I read focuses almost entirely on the PIP joint instead.
Posted @ Friday, May 07, 2010 8:48 PM by Ann
well , i have it , and idk how .Can you get it in a young age ? cause i got it when i was like .. 12 ? 11 ? close to there . 
Can i do something about it to make it stop besides surgery ? cause im still scared with those stuff :P 
ima 13 year old . soo , still scared . I want to prevent it from bending or make it stop without Surgery .  
Posted @ Monday, December 27, 2010 2:58 PM by Vang Moua
Well I'm 47 and my hands are messed up with RH arthritis.
Posted @ Saturday, January 08, 2011 1:15 AM by Old WASP
i had swans neck in both hand and had surgery. I was better of in splits cant bend 3 fingers they really hurt now doctor said that it did not work now they bend the other way .
Posted @ Thursday, April 21, 2011 1:03 PM by hayley
I have swan neck on my index finger from playing basketball.... have some swelling. Ordered the finger splint Oval-8. i dont want to have surgery.
Posted @ Thursday, June 07, 2012 11:00 AM by Sonny Olaes
I have swan neck fingers on both of my middle fingers, i have had splints but they did not work, so i had surgery on one hand. Surgery is very good and has pretty much sorted my finger out. The healing takes quite a long time, and the use of your hand is restricted for about 4 weeks. Learning to move your fingers again is the worst bit! 
Saying all this I have just recieved a date for the op on my other hand! 
As bad as the surgery sounds, it isn't, you get put under a general and they look after you so well. I wouldn't worry about it!  
My fingers are well on their way to becoming normal
Posted @ Monday, June 11, 2012 5:44 AM by Alicia
Hi, i was born with swan neck fingers. In all my fingers except my thumbs. Now once in a while they bother me because they can get jammed or locked in the fully extended position. But other than that I never had a problem. But what im look to know is am I looking a problem in my later years of life? And if so should i have surgery being born with them will the splits work?
Posted @ Thursday, June 28, 2012 11:41 AM by mike
Mike, my son is 8 and was born with swan neck in all fingers as well as he was diagnosed with EDS (Ehlers Danlos Syndrome) he is AMAZING at sports and I coach him in basketball, baseball, and football and I have concern that there will be a day where he cant play sports. He has never complained about any pain. I was curious of how many years you have lived with this and it you are into sports? My main concern is over time how bad will this get? Will it be to a point that he cant hardly move his fingers? My son not being able to play sports would be like taking everything he loves away from him so this has me very worried. My hope is that all the sports has strenthened his fingers and he can be the exception to the rule.
Posted @ Tuesday, August 21, 2012 8:00 PM by Noah
Hey, so I, my mother, sister, and grandmother were all born with swan-neck index fingers. However, while everyone else's are mild, mine are severe. We also can physically flex the tips of all our fingers to bend like that, but they don't stay that way. The index fingers do, however. I cannot straighten them without using my other hand to do so. 
 
I've always used my hands as a way to freak other kids out for entertainment (I'm 18 by the way). I hold a pencil differently than most (I kinda rest it on my first knuckle of my middle finger and let my first finger tip bend back), and I'm a talented artist. I've been pretty proud of being different, though knowing my mother's psoriatic arthritis is closely connected to RA, I'm pretty nervous about my future drawing abilities.
Posted @ Thursday, November 01, 2012 10:28 PM by Kayla Marie
I can make my hands do this with no discomfort at all, i'd like to know what its called when I can do this with my hands and return them back to normal, and how many people can do this as well.
Posted @ Friday, February 08, 2013 11:54 PM by tabi
Tabi, though I'm not a healthcare professional and therefore can't diagnose you, I'd suggest you follow the link to Ehlers Danlos in the above blog. The explanation there might help you further. All the best.
Posted @ Tuesday, February 12, 2013 3:18 PM by Heike
i first had a mallet finger which i never took notice of and that incident has happened for atleast 4 years and now i have a swan neck deforomity i never consulted to doc cause i was sacred as many told that they might amputed my finger but know i think i need to consult to a doc but im really sacred that will my finger get cured as i loft too long
Posted @ Saturday, March 30, 2013 9:50 PM by ayesha
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