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

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

Lunghezza: 81 pagine45 minuti

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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

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