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

By Kenneth Kee

This book describes Swan Neck Deformity, Diagnosis and Treatment and Related Diseases

A swan neck deformity is present on my right small finger probably due to an injury.
Anyway it is mild and does not cause any problem so I left it alone.

Swan neck deformity is the deformed condition of the finger, in which the joint that is closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it (DIP flexion with PIP hyper-extension).

It is often produced by injury or inflammatory disorders like rheumatoid arthritis or sometimes familial (congenital, like Ehlers-Danlos syndrome).

For a swan neck deformity to happen, abnormal stress must be placed on the ligament around the PIP joint of the finger.

The stress induces the ligament to release, which then produces hyperextension of the PIP joint.

As a result, the PIP joint bends in towards the palm.

At the same time, the joint furthest from the palm (DIP joint) pushes the fingertip to point towards the palm.

The abnormally bent fingers in a person with swan neck deformity may make it difficult for him or her to grasp objects or make a fist.

The limited movement may be categorized as a disability, as the person has lost some fundamental functions of the fingers and hands.

Swan neck deformity (SND) involves the fingers.

It happens when multiple joints in the fingers curve in unusual positions due to a health disorder or injury.

Swan neck deformity involves:
3 finger bones (phalanges)
2 inter-phalangeal joints, above the knuckle
Tendons
Ligaments

SND happens when the two inter-phalangeal joints point in unusual directions and cannot straighten into a flat position.

The middle joint of the finger may hyperextend, or bend upward.

This joint is termed the proximal inter-phalangeal (PIP) joint.

The end joint of the finger may also flex or bend downward.

This joint is termed the distal inter-phalangeal (DIP) joint.

The patient can only get Swan neck deformity in the fingers, but not affect the thumb.

The patient may also end up with mallet finger if just the end joint of the finger bends down.

Rheumatoid arthritis (RA) is the most frequent disease involving the PIP joint.

Chronic arthritis inflammation of the PIP joint places a stretch on the volar plate.

The volar plate is a supportive ligament in front of the PIP joint that normally stops the PIP joint from hyper-extending.

When the volar plate deteriorates and becomes stretched, the PIP joint becomes loose and starts to easily bend back into hyperextension.

The extensor tendon becomes out of balance, which permits the DIP joint to get pulled downward into flexion.

When the DIP joint flexes and the PIP joint hyper-extends, the Swan neck deformity happens.

Swan neck deformity can be caused by:
1. Rheumatoid arthritis (RA)
2. Cerebral palsy
3. Scleroderma
4. Psoriatic arthritis
5. Stroke
6. Parkinson’s disease
7. Some genetic disorders eg. Ehlers-Danlos syndrome
8. Trauma to the hand:
a. Untreated mallet finger – caused by injury
b. Poorly healed fracture in the finger
c. Other direct trauma to finger that has weakened the ligaments around the PIP joint
d. Nerve damage that produces muscle spasms
e. Severely jammed finger tip
f. Tightened hand muscles due to injury
g. Looseness of the fibrous plate inside the hand at the base of the fingers
h. Loose finger ligaments
i. Ruptured finger tendon or tendons

Physical or occupational therapy includes exercises, stretches, and massage to help the fingers improve balance and regain strength and mobility.

Surgical Treatment can be:
Soft Tissue Repair
Finger Joint Fusion
PIP Joint Arthroplasty

TABLE OF CONTENT
Introduction
Chapter 1 Swan Neck Deformity
Chapter 2 Causes<

• Language: English
• Publisher: Kenneth Kee
• Release date: Sep 18, 2020
• ISBN: 9781005267056

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

Swan Neck 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 2020 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 Swan Neck Deformity, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Swan Neck 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.

My diagnosis and treatment capability has improved tremendously from my continued education.

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

Swan Neck Deformity

A swan neck deformity is present on my right small finger probably due to an injury.

Anyway it is mild and does not cause any problem so I left it alone.

What is swan neck deformity?

Swan neck deformity is the deformed condition of the finger, in which the joint that is closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it (DIP flexion with PIP hyper-extension).

It is often produced by injury or inflammatory disorders like rheumatoid arthritis or sometimes familial (congenital, like Ehlers-Danlos syndrome).

For a swan neck deformity to happen, abnormal stress must be placed on the ligament around the PIP joint of the finger.

The stress induces the ligament to release, which then produces hyperextension of the PIP joint.

As a result, the PIP joint bends in towards the palm.

At the same time, the joint furthest from the palm (DIP joint) pushes the fingertip to point towards the palm.

The abnormally bent fingers in a person with swan neck deformity may make it difficult for him or her to grasp objects or make a fist.

The limited movement may be