What is Boutonnière deformity?

If you have not heard about Boutonnière deformity before, it is an injury to the tendons that are responsible for straightening the middle joint of the finger. As a result, the middle joint of the damaged finger will no longer straighten while the fingertip bends back. Unless the injury is promptly treated, the deformity will progress which results to permanent deformity and disrupted functioning.

Possible causes

Boutonnière deformity is typically caused by a strong shock on the top portion of a bent middle joint in a finger. This injury can also be caused by a wound on the upper part of the finger, which can separate the middle slip from its connection to the bone. The tear appears similar to a buttonhole and in some cases, the bone can pop through the opening. In some cases, the condition can also be caused by arthritis.

Boutonnière deformity

Pain and swelling can also occur and persist on the top of the middle joint of the finger.


The indications of Boutonnière deformity can develop right after an injury to the finger or develop 1-2 weeks later. The finger at the middle joint could not be straightened while the fingertip could not bend. Pain and swelling can also occur and persist on the top of the middle joint of the finger.

Diagnosing Boutonnière deformity

Since Boutonnière deformity is one of the various injuries that can occur from a jammed finger, a doctor should be consulted for proper assessment and treatment. The doctor will assess the fingers and hand. The individual is asked to straighten the finger and bend the fingertip. An X-ray might be required to check for any broken bones attached to the central slip of tendon.


It is important to note that Boutonnière deformity should be treated early to help the individual restore his/her full range of motion to the affected finger. If you want manage the symptoms, click here.

Non-surgical treatment options

In most cases, the non-surgical treatment options are usually the preferred choices which include the following:

  • Splints are applied to the finger at the middle joint to straighten it out. This will prevent the ends of the tendon from separating while it heals as well as allowing the end joint of the finger to bend. It is vital to use the splint continuously for the recommend time frame which is usually 6 weeks for young individuals and 3 weeks for the elderly.
  • Exercise which includes stretching is recommended to improve the flexibility and strength of the fingers.
  • Protection is vital if the individual engages in sports such as taping or splinting for several weeks after the splint is removed.

Those who have Boutonnière deformity instigated by arthritis are usually managed with corticosteroid injections or oral medications along with splinting.

Surgical options

Even though the non-surgical treatment options are initially preferred, surgery is also an option in some circumstances such as deformity that leads to rheumatoid arthritis or a severed tendon. If the condition does not improve with splinting and if there is a large bony fragment that is displaced from its normal position, it would require surgery.


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