Correction of the severe nonrheumatoid chronic boutonnière deformity with a modified Matev procedure

Twenty consecutive patients with severe chronic nonrheumatoid deformities were treated with a modification of the Matev procedure. Fourteen of the 20 had normal passive range of motion preoperatively, with the proximal interphalangeal joints lacking 59 degrees of active extension and the distal interphalangeal joints hyperextended 17 degrees. In the other six patients with PIP contracture at the time of reconstruction, PIP joints lacked 68 degrees of active extension and the DIP joints were hyperextended 13 degrees. Follow-up averaged 8 months, and at that time the patients with no contracture had an average of 14 degrees/96 degrees of active motion at the PIP joint and 9 degrees/59 degrees of motion at the DIP joint. The group with contracture had an average of 21 degrees/80 degrees of active motion at the PIP and 13 degrees/41 degrees of motion at the DIP joint. There were 85% good or satisfactory outcomes in the group without contracture and 67% good or satisfactory outcomes in the group with contracture.