ORTHOPEDICS/HAND & WRIST/FINGER DISORDERS
Finger Abnormality After Damage
A finger boutonniere abnormality is the consequence of a damage to the tendons, which task is to straightening the finger joints.
This damage commonly occurs during sports activities and people did not care enough thinking that they simply congested their finger.
The finger Boutonniere abnormality may accentuate as it may even generate to a lasting difficulty.
If diagnosed promptly, therapy may be operative.
A finger boutonniere abnormality, frequently happens due to a very significant damage to the finger tendons.
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The flexor tendons are on the finger palm side and pull the fingers down, facilitating a movement called finger flexion.
The extensor tendons are on the finger back and work to unbend the finger, facilitating a movement called finger extension.
Each one of the fingers has its own extensor tendon, and each one of the extensors tendon attaches to the bone in several places.
The finger three bones are called the phalanges (each one of these phalnges is called a phalanx) and are named according to their place: The distal phalanx is placed at the finger tip, the middle phalanx is between the lumps, and the proximal phalanx is placed at the finger base.
In normal state, the extensor tendon attaches to both the middle phalanx and the distal phalanx.
When the extensor attachment of the distal phalanx is damaged, it is called a mallet finger.
When the extensor tendon attachment of the middle phalanx is damaged, the result is the finger boutonniere abnormality.
The particular attachment of the extensor tendon on the middle phalanx is called the central slip,
So technically, a finger boutonniere abnormality is caused by a damage to the central slip.
Why the Finger Looks Wrong
The central slip is an important attachment of the extensor tendon.
This part of the extensor tendon pulls on the middle phalanx causing the middle part of the finger to unbend.
When the central slip is damaged, the first lump (the PIP joint) cannot unbend completely and looks somewhat permanently curved.
The finger boutonniere abnormality may result of finger mechanics complications, and when any finger part is torn, all the other parts may stop working normally.
In the case of the finger boutonniere abnormality, and because the PIP joint can’t unbend, the ligaments on the outside of the finger are shifted in their position; therefore, the abnormality of a finger Boutonniere is flexion of the PIP joint.
How It Happens
Typically, the finger boutonniere abnormality is caused due to a rounded force applied to the back of a bent finger.
As stated, this is frequently a sports or work damage.
Note that also a piercing, strong damage (such as a laceration) can cause a finger boutonniere abnormality.
Finger Boutonniere abnormality/classic signs
- Pain over the middle phalanx back
- Inflammation above the central slip
- Incapability to unbend the PIP joint or bend the DIP joint
Finger Boutonniere Abnormality/Therapy
Premature recognition of this damage is significant, since starting therapy, a month within the damage is generally enough to avoid surgical intervention.
Therapy consists of immobilizing the PIP joint in a completely straight position for at least 4-6 weeks.
Surgical alternatives to restore the tendon and reform the ligament can be helpful.
Furthermore, surgery may be recommended for some significant reasons of the finger boutonniere abnormalities including piercing damages and rheumatoid arthritis.