Managing Swan Neck and Boutonniere Deformities

Area of Science:

• Orthopedics
• Hand Surgery
• Biomechanics

Background:

• Acute and chronic injuries to the finger extensor mechanism can lead to complex deformities.
• These injuries disrupt the coordinated function of specialized extensor components, causing tendon imbalances.
• Imbalances alter interphalangeal joint forces, impacting flexion and extension capabilities.

Purpose of the Study:

• To review the nature of swan neck and boutonniere deformities resulting from extensor mechanism injuries.
• To discuss current treatment modalities, including splinting and surgical options.
• To evaluate the functional outcomes associated with surgical correction of these deformities.

Main Methods:

• Literature review of studies on finger extensor mechanism injuries.
• Analysis of treatment strategies for swan neck and boutonniere deformities.
• Assessment of surgical outcomes and potential complications.

Main Results:

• Swan neck deformities are significantly functionally limiting, with surgical correction generally yielding functional benefits.
• Boutonniere deformities, while aesthetically concerning, typically maintain proximal interphalangeal (PIP) joint flexion and fist-making ability.
• Surgical attempts to correct boutonniere deformities carry a risk of impeding flexion, potentially leading to poor functional outcomes.

Conclusions:

• Effective management of extensor mechanism injuries is crucial for restoring finger function.
• Surgical correction offers a viable solution for functionally limiting swan neck deformities.
• Careful consideration and cautious surgical approaches are necessary for boutonniere deformities to preserve essential flexion capabilities.