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Pediatric boutonniere deformity after blunt closed traumatic injury
Arash Izadpanah1, Ali Izadpanah, Hani Sinno
1Division of Plastic and Reconstructive Surgery, McGill University, McGill University Health Centre, Montreal, Quebec, Canada. arash.izadpanah@mail.mcgill.ca
Insights
Boutonniere deformity (BD) is rare in children. This case report highlights successful non-surgical treatment of acute traumatic BD in a 9-year-old girl, emphasizing early recognition and management for favorable outcomes.
Area of Science:
- Hand Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Boutonniere deformity (BD) is a common hand injury in adults, typically treated with splinting for acute cases or surgery for chronic conditions.
- While well-documented in adults, BD is exceptionally rare in the pediatric population, with limited established treatment guidelines.
Observation:
- A 9-year-old girl presented with an acute traumatic boutonniere deformity following a fall.
- The rarity of this condition in pediatric patients prompted referral to a plastic surgery clinic for specialized management.
Findings:
- The pediatric patient with acute traumatic BD was successfully treated with conservative splinting of the proximal interphalangeal joint in extension.
- Favorable functional results were observed within 4 weeks of initiating splinting treatment.
Implications:
- This case underscores the importance of recognizing and promptly managing acute traumatic boutonniere deformity in pediatric patients.
- Timely, appropriate splinting can lead to excellent outcomes, challenging the notion that surgical intervention is always necessary for pediatric BD.
Abstract:
The boutonniere deformity (BD) is a well-described condition in hand surgery. Treatment of acute traumatic BD includes splinting of the proximal interphalangeal joint in extension for 4 to 5 weeks, which often leads to acceptable results. However, the chronic BD is more problematic and often requires surgical intervention with poor functional outcomes. Boutonniere deformity is extremely rare in the pediatric population. We present the case of a 9-year-old girl who presented to the emergency department with an acute traumatic BD after a fall. Being an uncommon entity in this patient population, the patient was referred to the plastic surgery clinic and was subsequently treated appropriately with splinting, resulting in favorable results as early as 4 weeks. To our knowledge, this is the first reported case of BD in the pediatric patient population. Recognition and timely management of BD in a pediatric patient should not be overlooked to obtain favorable results.
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Assessment:
1. Clinical Evaluation:
History: