Causes and risk factors
Boutonniere deformity is more commonly caused due to trauma. Injury to the joint caused due to severe blow on the dorsal aspect of the finger can lead to this deformity. Severe cuts on the fingers which are deep can cause slipping of the tendon over the bone leading to a deformed finger. Lesser known causes are burns and infection. Boutonniere deformity can also be caused due to progression of arthritis.
Clinical presentation:
The complaints are seen either immediately after injury or 3 weeks after the trauma. Pain is a prominent feature seen. Along with this, swelling and bruising are other complaints. Weak grip is complained by the patient. The tip of the finger cannot be bent while the middle finger cannot be straightened. On examination, tenderness is present.
Investigations:
Considering the symptoms, a local examination is carried out by the orthopedic doctor. There is often a history of injury. Certain physical tests carried out help in confirming the diagnosis. X-ray of the carpal bones is done. Other investigations like CT scan or MRI can be done to find out the damage and involvement of the surrounding structures. RA factor test is done for confirming arthritis.
Treatment:
Rest, avoidance of stressful activity which will aggravate the complaint needs to be adopted. Application of ice pack for reducing the swelling is done. Analgesic or nonsteroidal anti-inflammatory drugs are advised by the orthopedic doctor for relief of the pain. Splint is applied to the middle finger for immobilization for 3-6 weeks. If the person is involved in some sports activity, wearing of protective splints and tapes is advised. Surgical intervention can also be done in severe cases. There are a variety of techniques or methods for surgical repair. As recovery starts, certain physiotherapy exercises are advised under the guidelines of a trained physiotherapist.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.
