How a Boutonnière Deformity Is Treated

How a Boutonnière Deformity Is Treated

A boutonnière deformity is a type of hand injury that affects the tendons and joints in a finger. A hard blow, a deep cut, or even arthritis can cause tendon damage in a finger, which can make the middle joint jut upward and the tip of the finger jut upward as well.

A boutonnière deformity makes it impossible to straighten the finger. It’s painful, and it requires prompt care to prevent permanent loss of finger function. Fortunately, treatment can effectively relieve symptoms.

If you’ve suffered a hand injury, Kristopher Downing, MD, & James Andry, MD at Upper Extremity Specialists, of Ortho 1 Medical Group, can perform a thorough evaluation and give you the treatment you need to get well.

In this blog, Dr. Downing explains more about what a boutonnière deformity is and how it can be treated.

The basics of a boutonnière deformity

The tendon that runs along the top of your finger is called the central slip extensor, and if it gets injured, it can pull the joints of your finger into a boutonnière deformity. As mentioned, this condition makes the middle joint jut upward and makes the tip of the finger jut upward as well.

The most common causes of a boutonnière deformity are:

A boutonniere deformity usually develops within three weeks after a finger injury. It’s important to get a diagnosis and start treatment as soon as possible. Letting your symptoms go untreated for more than three weeks could increase your risk of permanent mobility loss.

To see if you have a boutonniere deformity, Dr. Downing examines your hand and finger. He may also order X-rays or other medical imaging. Treatment for a boutonnière deformity depends on the severity of your injury and the underlying cause. Depending on your case, Dr. Downing may recommend nonsurgical or surgical options.

Nonsurgical treatments for a boutonnière deformity

Nonsurgical treatments can be very effective in relieving symptoms and preserving finger function. Here are some common ones:

Splinting and taping

A finger splint can hold your finger’s middle joint in a straight position and allow the tendon to heal. You may need to wear the splint for several weeks. Even after removing your splint, Dr. Downing may recommend taping to support and protect your finger.

Physical therapy

Dr. Downing may give you a series of exercises for your finger and hand. Physical therapy can strengthen the muscles and tendons in your finger to help improve range of motion and function.


If you’re bothered by pain and inflammation in your finger, Dr. Downing may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to lessen your symptoms as you heal.

Surgery for a boutonnière deformity

While nonsurgical treatments are effective for many people dealing with a boutonnière deformity, some people may need more advanced treatment. Dr. Downing may recommend surgery if:

The specific surgical procedure you need will depend on your case, but the goal will be to repair the damaged tendon and correct the deformity. After surgery, Dr. Downing will splint your finger, and you’ll start physical therapy to help improve your range of motion and strength.

If you’re worried you might have a boutonnière deformity, seek medical attention as soon as possible. Early treatment can help prevent long-term complications and improve your chances for a full recovery. To learn more, book an appointment online or over the phone with Upper Extremity Specialists today. We have offices in Chula Vista and La Jolla, California.

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