Boutonniere Deformity: Muscle, Joint Disorder | Causes and Treatment

What is Boutonniere Deformity ?

A boutonniere deformity occurs when there has been an injury to the tendons, which are responsible for the straightening of the middle joint of the fingers. It means that the middle joint of your fingers is not flexible enough to straighten completely.  This can happen to anyone who has had an injury to the tendons of the fingers. In rare cases, the deformity can occur in your toes, if injured.

Here is a simple guide to Boutonniere deformity, its causes, and treatments.

What are the Causes of Boutonniere Deformity?

There are several causes of Boutonniere Deformity. While an injury to the central slip extensor tendon in your hand is a common cause of the deformity. The tendon often has a slit, and if it is not corrected, the deformity can last longer and it can become permanent.

Another cause of it is arthritis. Arthritis affects joints and bones and can cause severe restrictions on movement. This can also result in Boutonniere deformity, if not treated on time. In rare cases, it can also be a result of a birth defect. It is always advisable to consult a doctor to find out the root cause of it, which will help in planning a treatment process.

What are the Symptoms of Boutonniere Deformity?

It is important to understand how your fingers function, and figuring out symptoms will help identify some of them, which can aid in addressing them as soon as you can. Here are some of them.

If it is an injury, the symptoms will show up within a few hours, where the fingers will be bent, and movement will be very limited. Sometimes, it may take a few weeks, and the bend can form over that period of time. Another symptom will be pain and swelling in the joints of your fingers, which restrict movement. Different types of Boutonniere Deformity include boutonniere deformity of a finger, boutonniere deformity of thumbs, and more. 

How to Diagnose Boutonniere Deformity?

The symptoms are a good sign to look at the diagnosis for it. If there is limited movement, stiffness in your finger joints, or if there is no movement to straighten your fingers, they could mean deformity. 

It is best to visit a doctor, who will run scans and tests, to check if there is any injury to the tendon and joints, which may result in Boutonniere deformity. An Elson’s Test may be conducted on your finger, to ascertain the damage. Simple flexing exercises by the doctor, such as asking you to bend your fingers, pressing on the joint, can help ascertain the cause for it and diagnosis.

Treatment for Boutonniere Deformity

Treating it early, by a medical professional can help in regaining movement to a full extent. Some of the common treatments are as follows.

Nonsurgical options such as splints, crepe bandages are used to straighten the joints, allowing the tendons to heal without any severance due to movements. This is usually done for about 3 to 6 weeks based on the medical history and age of the individual. Medication for arthritis, inflammation reducers can also be used to treat the deformity, along with boutonniere deformity splints.

Surgical intervention may be needed if there is severe damage to the tendons and joints. This will be performed by a medical professional, after evaluating the need and process for the same. Surgery may be performed if there is damage to bone fragments or if there is no recovery after using splints.

Physiotherapy Treatment for Boutonniere Deformity

Physiotherapy to treat Boutonniere deformity will depend on factors such as your medical history, the intensity of the injury, and other factors. Once a full test is done, a physiotherapist may chart a plan.

It can involve the basic stretching exercises of the finger, palm, and hands. Besides these, strengthening exercises such as squeeze balls can be introduced, based on the recovery and recommendations of the physiotherapist.

Cautionary Advice

It is important to see a professional as early as you can, as the deformity, if prolonged, can result in severe interruption of movement. It can also be a sign of arthritis - which needs to be addressed as early as you see the symptoms, as it can result in severe joint pains across the body. It is also important to get X-rays and scans done, in order to prevent any further damage to the tendons. Care and patience are important while dealing with Boutonniere's deformity.