From the Research
A patient with a boutonnière deformity should ideally be seen by a hand surgeon within 2-3 weeks of injury for the best treatment outcomes. Early intervention is crucial because untreated boutonnière deformities can become fixed and more difficult to correct over time. For acute injuries (less than 3-4 weeks old), conservative treatment with splinting is often effective, while chronic deformities may require surgical intervention.
- The most recent and highest quality study 1 suggests that relative motion flexion splinting can be an effective treatment for both acute and chronic boutonnière deformities, allowing for early active motion and hand use with excellent range of motion achieved.
- Key points to consider when treating boutonnière deformities include:
- Immobilizing the affected finger with the proximal interphalangeal (PIP) joint in full extension using a dorsal splint while waiting for the appointment.
- Wearing the splint continuously for 6-8 weeks, removing it only for hygiene purposes, to help the central slip of the extensor tendon heal in the proper alignment.
- Considering surgical intervention for chronic deformities or cases where conservative management is not effective.
- It is essential to prioritize morbidity, mortality, and quality of life when making treatment decisions, and to consider the individual patient's needs and circumstances when determining the best course of treatment.
- The study 1 provides evidence that relative motion flexion splinting can be a safe and effective alternative to surgery for chronic boutonnière deformities, with excellent results and low morbidity.