Expert Boutonniere’s Deformity Treatment in Delhi
What is Boutonniere’s Deformity ?
Boutonnière deformity is a hand condition characterized by a specific posture of the finger: the middle joint (proximal interphalangeal or PIP joint) is bent inward (flexed), and the outermost joint (distal interphalangeal or DIP joint) is bent backward (hyperextended). This resembles a “buttonhole,” which is where the name “boutonnière” (French for buttonhole) comes from.
Causes of Boutonniere’s Deformity
The deformity usually results from injury to the central slip of the extensor tendon, which is responsible for straightening the PIP joint. Common causes include:
- Trauma: A direct blow to the top of a bent middle finger joint, a laceration that severs the tendon, or a dislocation.
- Inflammatory Arthritis: Rheumatoid arthritis is a significant cause, where chronic inflammation damages the tendons and surrounding tissues.
- Osteoarthritis: Can also contribute to the deformity in some cases.
- Burns: In rare cases, burns can lead to Boutonnière deformity.
- Congenital: Very rarely, it can be present at birth.
Role of Physiotherapy in Boutonniere’s Deformity
Conservative Management: This is often the first line of treatment.
- Splinting: The key is to hold the PIP joint in full extension for an extended period (weeks to months) while allowing the DIP joint to move. This lets the central slip heal.
- Pain & Inflammation Management: Ice, heat, and other modalities can be used.
- Patient Education: Crucial for adherence to splinting and exercises.
Therapeutic Exercise Program: Once initial healing begins or immobilization is complete.
- Range of Motion (ROM) Exercises: Gentle movements for the DIP joint (while PIP is splinted) and later for the PIP joint to regain flexibility.
- Strengthening Exercises: Gradually introduced for finger and hand muscles to improve grip and function.
- Stretching: To address any developing stiffness or contractures.
- Functional Exercises: Integrating exercises into daily activities to restore normal hand use.
Post-Surgical Rehabilitation: If surgery is needed, physiotherapy guides the post-operative recovery, focusing on protected mobilization, scar management, and progressive strengthening.
To restore full range of motion, strength, and function to the affected finger, preventing long-term stiffness and disability.
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