Treating the Proximal Interphalangeal Joint in Swan Neck and Boutonniere Deformities.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 9. J Hand Surg Am. 1990 Nov;15(6):999-1003. doi: 10.1016/0363-5023(90)90032-m. Boutonniere rheumatoid thumb deformity. Terrono A(1), Millender L, Nalebuff E. Author information: (1)New England Baptist Hospital, Boston, Mass. The boutonniere deformity is the most common rheumatoid thumb deformity. It can be classified into early, moderate, and advanced types, depending on whether the deformity is passively correctable. Fifty-three patients with 74 procedures form the basis of these recommendations. The early type treated with metacarpophalangeal joint synovectomy and extensor pollicis longus rerouting have a high recurrence rate of 64%. Metacarpophalangeal joint fusion is the procedure of choice for the moderate type with isolated metacarpophalangeal joint involvement. Metacarpophalangeal joint arthroplasty is best suited for the low-demand, older patients with borderline proximal and distal joints. Interphalangeal joint releases done with metacarpophalangeal joint fusions have a high recurrence rate and are not recommended. In advanced cases metacarpophalangeal joint arthroplasty and interphalangeal joint fusion is our procedure of choice. DOI: 10.1016/0363-5023(90)90032-m