What is a pseudo boutonniere deformity?
The pseudo-boutonniere deformity is a boutonneire-like deformity resulting from a hyperextension injury to the proximal interphalangeal joint causing tearing of the volar soft tissues. It is seen almost exclusively in the little and ring fingers.
Why is it called buttonhole deformity?
The extensor tendon is disrupted and the lateral aspects of the tendon separate. The head of the proximal phalanx subsequently projects through the disrupted tendon elements. This deformity obtained its name presumably due to its appearance to a buttonhole on surgical exploration.
What is boutonniere and swan neck deformity?
Posttraumatic boutonnière and swan neck deformities are complex clinical problems that are often poorly understood. A boutonnière deformity consists of flexion of the proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint.
What causes a boutonniere deformity?
Boutonnière deformity is generally caused by a forceful blow to the top (dorsal) side of a bent (flexed) middle joint of a finger. It also can be caused by a cut on the top of the finger, which can sever the central slip (tendon) from its attachment to the bone.
What is Z deformity?
The Z deformity is one of the musculoskeletal manifestations of rheumatoid arthritis in hand: radial deviation at the wrist. ulnar deviation of the digits, and often. palmar subluxation of the proximal phalanges.
What tendon is injured in boutonniere deformity?
A Boutonniere deformity is a deformity of the fingers in which the proximal interphalangeal joint (PIP) is flexed and the distal interphalangeal joint (DIP) is hyperextended. It is an extensor tendon injury over zone III. It is also referred to as a “buttonhole deformity.”
What is Z deformity of thumb?
Terminology. Hitchhiker thumb deformity, also known as Z-thumb or duckbill thumb, is used to both describe the appearance of the thumb on physical examination and also the corresponding radiographic appearance. It is similar to how a person would normally angulate and hold out the thumb with the intention to hitchhike.
What is pseudo boutonnière deformity?
A pseudo-boutonnière deformity is described; it is characterised by flexion contracture of the proximal interphalangeal joint, hyperextension of the distal joint, and radiological evidence of calcification, anterior or volar to the proximal phalanx.
What is the best treatment for a Boutonniere deformity?
Boutonniere deformity can be graded into Nalebuff and Millers Classification, which guides the appropriate treatment pathway. The purpose of splinting is is to achieve full PIPJ extension whilst DIPJ passive flexion exercises are being done. This should be continued for a minimum of 8 weeks to gain the maximum possible correction.
What is the difference between a swan-neck and a Boutonniere deformity?
Unlike a Swan-neck deformity, it is more of an aesthetic issue than a functional – patient can still make fists. A Boutonniere deformity has the classic signs of MPCJ extension, PIPJ flexion, DIPJ extension. Boutonniere means “buttonhole” in French – the appearance of the PIPJ through the migrated lateral bands 8.
