Boutonniere Deformity, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Boutonniere Deformity, Diagnosis and Treatment and Related Diseases
Boutonniere deformity is a medical disorder where the finger is flexed at the proximal inter-phalangeal joint (PIP), with hyperextension at the distal inter-phalangeal joint (DIP).
This is normally a result of injury in the acute setting and is produced by force applied to the top of a bent middle joint of a finger.
There is a direct trauma to the central slip that damages the extensor function of the affected digit.
A boutonniere deformity can also happen from a laceration on the top of a finger, which can cut the tendon and detach it from the bone.
It can also happen if the patient would have a full-thickness burn resulting in direct damage to the central slip.
More often, it is due to an inflammatory disorder, such as rheumatoid arthritis.
Boutonniere deformity is often due to damage to the tendons that straightens the middle joint of the finger.
The result is that the middle joint of the injured finger will not extend or straighten, while the fingertip flexes back.
Unless this damage is treated rapidly, the deformity may go on, causing permanent deformity and impaired functioning.
The deformity got its name because the injury caused the proximal phalanx to protrude through like a finger through a buttonhole (hence the term, from French boutonniere, which is translated into buttonhole).
Football and basketball are the most frequent cause of sports-related boutonniere deformities.
Boutonniere deformity is normally produced by a forceful blow to the top (dorsal) side of a bent (flexed) middle joint of a finger.
Symptoms
Symptoms can be instant or delayed for several weeks.
If the injury happens as a result of a laceration, the area needs to be completely cleansed and examined in a “bloodless field” for tendon reliability.
This can easily be achieved by using a glove.
The doctor simply cuts the finger off a glove and places on the affected digit and then cuts a small hole at the distal aspect of the finger glove.
The doctor then rolls the finger glove proximally until it forms a “ring” at the base of the digit which will work as a tourniquet.
The status of the tendon will decide treatment methods.
If rheumatoid arthritis produces a boutonniere deformity, a comprehensive history should involve the length of symptoms, medicines (previous and current), level of pain and degree of disability.
Signs of boutonniere deformity can form instantly after an injury to the finger or may form a week to 3 weeks later.
The finger at the middle joint cannot be extended and the fingertip cannot be flexed.
Swelling and pain happen and go on the top of the middle joint of the finger.
Diagnosis
Elson test is the most dependable way to diagnose a central slip injury before the deformity is evident
X-rays are indicated to find if there are any broken bones attached to the central slip of tendon.
Lateral radiographs can be used to find out the degree of hyperextension
Treatment
Boutonniere deformity must be treated early to help the patient keep the full range of motion in the finger.
The purpose of treatment is to regain full range of movement of the affected finger.
Treatment methods are both surgical and non-surgical methods.
A splint will be applied to the finger at the middle joint to keep it straight.
This prevents the ends of the tendon from dividing as it heals.
It also permits the end joint of the finger to bend.
The doctor may advise stretching exercises to increase the strength and flexibility in the fingers.
If non-surgical measures are not successful, surgical joint replacement or bone fusion may be required
Surgery can decrease pain and increase function.

TABLE OF CONTENT
Introduction
Chapter 1 Boutonniere Deformity
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
C

• Language: English
• Publisher: Kenneth Kee
• Release date: Aug 31, 2019
• ISBN: 9780463762790

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Boutonniere Deformity,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Boutonniere Deformity, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Boutonniere Deformity)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Boutonniere Deformity

What is Boutonniere deformity?

Boutonniere deformity is a medical disorder where the finger is flexed at the proximal inter-phalangeal joint (PIP), with hyperextension at the distal inter-phalangeal joint (DIP).

This is normally a result of injury in the acute setting and is produced by force applied to the top of a bent middle joint of a finger.

There is a direct trauma to the central slip that damages the extensor function of the affected digit.

A boutonniere deformity can also happen from a laceration on the top of a finger, which can cut the tendon and detach it from the bone.

It can also happen if the patient would have a full-thickness burn resulting