Swan Neck Deformity

Swan Neck Deformity

Each hand consists of 27 bones which comprises of 14 phalanges, 5 metacarpal bones, and 8 carpal bones. These bones provide support and flexibility for manipulating objects. The phalanges (finger bones) are connected to each other by interphalangeal joints. These are distal and proximal interphalangeal joints. Proximal interphalangeal joint is the joint between the first and second phalanx while the joint between the second and third phalanx is the distal interphalangeal joint. Swan neck deformity is a joint disorder of the finger characterized by hyperextension of the proximal interphalangeal joint and flexion of the distal interphalangeal joint.

Causes and risk factors

Swan neck deformity is caused due to trauma. Injury to the joint caused due to severe blow on the dorsal aspect of the finger can cause rupture to the tendon of the finger resulting in deformity. Misalignment of the healing fractured bone of the finger along with spasms of the muscle or weakness of the volar plate are other contributing factors. Mallet finger is characterized by injury to the thin tendon due to which the end point of the finger cannot be straightened. This mallet finger when untreated can result in swan neck deformity. Arthritis, especially rheumatoid arthritis, is another major cause. Various diseases of the nerve like Parkinson’s disease, stroke, or cerebral palsy, or injuries causing nerve damage can result in this deformity.

 

Clinical presentation:

Finger other than thumb are more commonly affected. The proximal part of the affected finger is straight while the distal part is bent. Stiffness along with difficulty in movement is seen. Weak grip is seen. Pain can also persist in a few cases. On examination, tenderness is present.

 

Investigations:

Considering the symptoms, a local examination is carried out by the orthopedic doctor. There can be a history of injury or some joint or nerve disorder. Certain physical tests carried out helps 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:

Correcting the underlying cause is the main aim of the treatment. Massage, stretching, and physical exercises are advised for strengthening and flexibility. Analgesic or nonsteroidal anti-inflammatory drugs are advised by the orthopedic doctor for relief of the pain.  Splint is applied to the affected finger. Surgical intervention can be done. It consists of repairing the soft tissues. Realignment of the joints can be done. Arthroplasty and finger joint fusion is another surgical technique. If the person is involved in some sports activity, wearing protective splint and tape is advised.

 

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.

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