Boutonnire Deformity of Finger

Boutonnière deformity (BD) prevents you from straightening your finger. The disorder affects the finger’s system of tendons. The tendons allow you to flex and straighten your finger.

  • Causes


    In BD, the tendon on the top of the finger (called the central slip) is torn or cut from the other tendons. This creates a tear that resembles a buttonhole (or
    boutonnière
    in French). The middle joint is forced down and the fingertip bends back. The tendons on this part of the finger are flat and thin. They are prone to injury. If you have BD in the thumb, it affects a joint called the metacarpophalangeal (MCP).


    BD can be caused by:

    • A powerful blow to the finger
    • A cut to the finger’s central slip
    • An injury to the middle finger joint (called the proximal interphalangeal [PIP] joint)
    • A severe burn on the hand

  • Definition

    Boutonnière deformity (BD) prevents you from straightening your finger. The disorder affects the finger’s system of tendons. The tendons allow you to flex and straighten your finger.

    Tendons in Finger
    Finger Tendon
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis


    Your doctor will ask about your symptoms and medical history. A physical exam will be done, paying close attention to:

    • Muscle strength
    • Joint damage
    • Range of motion
    • Presence of swelling
    • Evidence of infection
    • Tenderness in the finger


    An
    x-ray
    may be done to see if you have a fracture.

  • Prevention


    To help reduce your chance of getting BD, take the following steps:

    • Wear the proper equipment when playing sports.
    • If you have rheumatoid arthritis, ask you doctor about ways to protect your joints.

  • Risk Factors


    These factors increase your chance of developing BD:


    • Having
      rheumatoid arthritis
      or
      Dupuytren’s contracture
    • Participating in rough sports, especially those involving catching and throwing balls (eg, football, basketball)

    Tell your doctor if you have any of these risk factors.

  • Symptoms


    If you have any of these symptoms, do not assume it is due to BD. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

    • Pain and swelling on the top of the finger’s middle joint (the PIP joint)
    • Inability to straighten finger at the middle joint

    • Sign of injury (such as
      fracture
      or
      dislocation) to the PIP joint
    • Sign of injury (such as fracture or dislocation) to the MCP joint

  • Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following: