Operative treatment of the chronic post-traumatic boutonnière deformity by the technique of pieper

We report eleven cases of chronic, non-fixed, post-traumatic boutonnière deformity treated by the technique of Pieper: One lateral slip was mobilised and distally desinserted. At the PIP, the slip was pulled through the central slip and sutured in correct tension to the released opposite lateral slip. 73 % regained full extension at the proximal interphalangeal joint. Despite a mild extension deficit of 15 degrees at the distal interphalangeal joint in 64 %, ten of eleven patients were content with the post-operative outcome. We conclude that the technique of Pieper is a good and valuable operative procedure to correct chronic non-fixated button-hole deformity.