Abstract
Rheumatoid finger deformities can limit hand function significantly in patients with rheumatoid arthritis (RA). A swan-neck deformity is ultimately the result of hypertrophied rheumatoid synovium and consists of hyperextension at the proximal interphalangeal (PIP) joint with a flexion deformity at the distal interphalangeal (DIP) joint. Although the deformity usually begins at the PIP joint, it can also result from the destructive effect of synovitis at the metacarpophalangeal (MCP) joint or the DIP joint. In comparison, a boutonnière deformity is caused by synovitis at the PIP joint and is characterized by flexion of the PIP joint with hyperextension of the DIP joint. Surgical correction of these rheumatoid finger deformities depends on the severity of the deformity and aim to improve function and relieve pain in the affected hand. This chapter is intended to provide detailed explanations of current surgical techniques available to treat swan-neck and boutonnière deformities and the indications for each procedure.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Boyer MI, Gelberman RH. Operative correction of swan-neck and boutonniere deformities in the rheumatoid hand. J Am Acad Orthop Surg. 1999;7(2):92–100.
Nalebuff EA. The rheumatoid swan-neck deformity. Hand Clin. 1989;5(2):203–14.
O’Brien ET. Surgical principles and planning for the rheumatoid hand and wrist. Clin Plast Surg. 1996;23(3):407–20.
Green DP. Operative hand surgery, vol. 2. 3rd ed. New York: Churchill Livingstone; 1993. p. 1654–70.
Tonkin MA, Hughes J, Smith KL. Lateral band translocation for swan-neck deformity. J Hand Surg Am. 1992;17(2):260–7.
Sirotakova M, Figus A, Jarrett P, Mishra A, Elliot D. Correction of swan neck deformity in rheumatoid arthritis using a new lateral extensor band technique. J Hand Surg Eur Vol. 2008;33(6):712–6.
Kiefhaber TR, Strickland JW. Soft tissue reconstruction for rheumatoid swan-neck and boutonniere deformities: long-term results. J Hand Surg Am. 1993;18(6):984–9.
Gainor BJ, Hummel GL. Correction of rheumatoid swan-neck deformity by lateral band mobilization. J Hand Surg Am. 1985;10(3):370–6.
Olazabal A. Surgery of the rheumatoid wrist and hand. J Bone Joint Surg Br. 2008;90(Supp 2):262.
Nalebuff EA, Millender LH. Surgical treatment of the boutonniere deformity in rheumatoid arthritis. Orthop Clin North Am. 1975;6(3):753–63.
Williams K, Terrono AL. Treatment of boutonniere finger deformity in rheumatoid arthritis. J Hand Surg Am. 2011;36(9):1388–93.
Slesarenko YA, Hurst LC, Mai K. Suture anchor technique for anatomic reconstruction in chronic boutonniere deformity. Tech Hand Up Extrem Surg. 2005;9(3):172–4.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Olazábal, A., Mathews, A.L. (2016). Treatment of Boutonniere and Swan-Neck Deformities in Rheumatoid Fingers. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. https://doi.org/10.1007/978-3-319-26660-2_19
Download citation
DOI: https://doi.org/10.1007/978-3-319-26660-2_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-26658-9
Online ISBN: 978-3-319-26660-2
eBook Packages: MedicineMedicine (R0)