Boutonniere Deformity Treatment in Kenya

Boutonnière deformity is the result of an injury to the tendons that straightens the middle joint of your finger. It is also referred to as a “buttonhole deformity.”

The result is that the middle joint of the injured finger will not straighten, while the fingertip bends back. Unless this injury is treated promptly, the deformity may progress, resulting in permanent deformity and impaired functioning.

Boutonnière deformity is generally caused by a forceful blow to the top side of a bent middle joint of a finger. It’s often caused by rheumatoid arthritis.

Other causes of boutonnière deformity

It also can be caused by a cut on the top of the finger, which can sever the central tendon from its attachment to the bone. Other possible causes include:

1. finger dislocation
2. finger fractures
3. osteoarthritis

Signs of boutonnière deformity can develop immediately following an injury to the finger or may develop a week to 3 weeks later.

What is the treatment for a boutonniere deformity?

Boutonnière deformity must be treated early to help you retain the full range of motion in the finger.
There are non-surgical and surgical treatment options for the deformity. Treatment will depend on the severity of the irregularity.

The nonsurgical treatment is usually preferred, and may include:

1. Splints: A splint will be applied to the finger at the middle joint to straighten it. This keeps the ends of the tendon from separating as it heals. It also allows the end joint of the finger to bend.
   It is important to wear the splint continuously for the recommended length of time. Following this period of immobilization, you may still have to wear the splint at night.
2. Exercises: Your physician may recommend stretching exercises to improve the strength and flexibility of the fingers.
3. Protection: If you participate in sports, you may have to wear protective splinting or taping for several weeks after the splint is removed.

People with boutonnière deformity caused by arthritis may be treated with oral medications or corticosteroid injections, as well as splinting.

Surgical Treatment Options 

While non-surgical treatment of boutonnière deformity is preferred, surgery is an option in certain cases, such as when:

1. The deformity results from rheumatoid arthritis.
2. The tendon is severed.
3. A large bone fragment is displaced from its normal position.
4. The condition does not improve with splinting.

 Surgery can reduce pain and improve functioning, but it may not be able to fully correct the condition and make the finger look normal. If the boutonniere deformity remains untreated for more than 3 weeks, it becomes much more difficult to treat.

Correction is not without complexity. While there is an attempt at the improvement in function, patients may experience any of the following:

What can a hand therapist at Nairobi Spine and Orthopaedic Centre do for you?

For a boutonniere deformity that does not require surgery, a hand therapist will make a custom orthosis to place the finger in a proper position for correct healing. The therapist will also instruct the person in techniques to reduce swelling in the finger.

The hand therapist will also instruct the person in a specialized home exercise program that will assist with return to normal hand function.

If you are struggling with a boutonniere deformity, contact Nairobi Spine and Orthopaedic Centre in Kenya for a visit, and let’s get you on the road to recovery.