Seek Immediate Treatment for Boutonniere Deformity
Posted on Tue, Oct 05, 2010 @ 01:12 PM
If you have sustained a jamming or crushing injury to your finger and it has been swollen for more than a couple of days and you are unable to straighten your middle knuckle, you may have what is known as a Boutonniere Deformity. You need to seek immediate medical treatment. A jammed finger might seem like no big deal but the balance of tendons and ligaments in the finger is very delicate and this balance needs to be restored as quickly as possible. Delaying treatment thinking the finger will get better on its own may lead to a permanent deformity that cannot be corrected even with surgery. Finger swelling must be dealt with right away and if your doctor splints your finger you must leave the splint on as instructed.
Boutonniere Deformity involves the tendons and ligaments of the fingers. The central slip is the top sheet of a complex arrangement of tissues on the top side of the fingers. The central slip helps straighten the PIP joint (middle knuckle) and bend the DIP joint (end knuckle).
When a finger sustains a jamming or crush injury, the middle finger bone can tear through the central slip leaving a hole that the bone can extend through. This causes the tendons and ligaments that normally work to straighten the PIP joint to now bend it instead. These same tendons and ligaments normally work to bend the DIP joint but with the injury, they now hyperextend the fingertip and it bends backward. This simultaneous bending of the PIP and hyperextending of the DIP defines a Boutonniere Deformity.
The symptoms of Boutonniere Deformity are a finger where the PIP (middle) joint is stuck in flexion (bent toward the palm) and the DIP (end) joint hyperextends (bends backwards). When Boutonniere Deformity is caused by a jamming injury the middle joint of the finger may be enlarged and painful to the touch for several weeks after the injury has occurred. Signs of Boutonniere Deformity can develop right after an injury or may develop later.
It cannot be stressed enough that early treatment is the best way to keep a jammed finger from becoming a permanent deformity. Your family doctor may refer you to a Hand Surgeon, usually an orthopedic or plastic surgeon who specializes in treating problems of the hand or arm. There are several injuries that can occur when you jam your finger and it is very important to have your injury evaluated and obtain an accurate diagnosis and treatment plan.
Your doctor will perform an examination of your fingers and hand to evaluate your injury. X-rays may be needed to detect any broken bones. If you receive a diagnosis of Boutonniere Deformity that has been caused by an injury there are several non-surgical options for treatment. The best treatment for Boutonniere Deformity is early treatment with appropriate splinting or casting. Generally you will need to wear a splint for 4 or more weeks and it is important to wear the splint as directed by your doctor or therapist. The purpose of splinting the middle joint is to immobilize the joint and allow the ligaments and tendon to heal back into their proper alignment. Your doctor or therapist might also prescribe stretching exercises and protective splinting or taping for sports activity after your splint is removed.
There are situations where surgery may be the best treatment option for Boutonniere Deformity. Surgery can improve finger function and reduce pain but may not fully correct the condition. Cases of Boutonniere Deformity that may indicate a surgical option may include cases where:
- the tendon is severed,
- displacement of a large bone fragment has occurred, or
- splinting has not improved the condition.
If you receive a diagnosis of Boutonniere Deformity, there are effective splinting options available to you. It is important to have your injury or condition properly evaluated by your health care provider. For additional information and videos about splints that help in treating Boutonniere Deformity please follow the links below and remember to share the information with and consult your doctor before undertaking any course of treatment.
http://www.3pointproducts.com/buddy-loop/
http://www.3pointproducts.com/oval-8-finger-splint/
http://www.3pointproducts.com/3pp-step-up-splint/
Author: Julie Belkin