Boutonnière Deformity | Orthopaedics | Loyola Medicine

Boutonnière Deformity

Overview and Facts about Boutonnière Deformity

Boutonnière deformity is an orthopedic condition that causes the middle joint of one of your fingers to bend, preventing you from straightening it. This also causes your fingertips to bend outward and back. Generally, boutonnière deformities are the result of an injury, but there can be other causes.

If you are experiencing boutonnière deformity, it is important to seek treatment, otherwise, the limited finger mobility might become permanent.

Signs and Symptoms of Boutonnière Deformity

You may begin to notice the symptoms of boutonnière deformity right after your injury or up to three weeks afterward. They can include:

  • Pain when trying to straighten out the affected joint
  • Inability to bend the fingertip
  • Swelling around the middle joint of the finger

Causes and Risk Factors of Boutonnière Deformity

The most prominent cause of boutonnière deformity is a strong impact to the finger. For example, if your finger is bent or flexed and then gets hit on the top, the force can injure the tendons, which causes boutonnière deformity. Boutonnière deformity can also happen if your finger is cut and the tendon underneath slips out of position.

However, other orthopedic conditions can contribute to the development of boutonnière deformity. These include:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Finger fractures and dislocations

Tests and Diagnosis of Boutonnière Deformity

The only way to know for sure if you have boutonnière deformity is to receive a physical examination by a doctor. They will check to make sure it’s not another similar injury, such as swan neck deformity. In this condition, it’s the base of your finger that bends in, not the middle joint.

To make the proper diagnosis, your doctor may take X-rays to get a look at the internal structures of your hand, as well as see whether you can straighten and bend your finger.

Treatment and Care for Boutonnière Deformity

Luckily, when you receive early treatment for boutonnière deformity, the chance of getting back your full range of motion is good. Treatment options include:

  • Splinting to immobilize the finger and keep it straightened as it heals. You usually need to wear the splint for three to six weeks
  • Exercises to improve flexibility and range of motion
  • Medications to reduce swelling and inflammation

Surgery usually isn’t necessary unless you have a more serious injury, such as a severed tendon or severe rheumatoid arthritis. In surgery, your doctor will repair your tendons to straighten your joints. Recovery time is about 12 weeks.