Boutonnerie Deformity/Mallet Finger/Jersey Finger

Boutonniere Deformity Physical Exam

*Boutonniere: PIP flex, DIP extend* Swan neck: PIP extend, DIP flex

What is a Boutonniere Deformity

*Extensor tendon slip injury* associatd with dorsal lip fx's

Cause of Boutonniere Deformity

*Finger struck by object* or related to *rheumatoid arthropathy*

Boutonniere Deformity Tx

*Splint in full extension* for up to 6 weeks if associated with tendon tear. *Buddy tape 4-6 weeks* Return to play or work once pain is controlled

Cause of Jersey Finger

Contact sport athlete who reaches out with *flexed fingers* to grab a jersey and opponent pulls away causing sudden extension

Cause of Mallet Finger

Direct blow to the fingertip

What is a Mallet Finger

Disruption of the terminal *slip of the extensor tendon* at the *DIP joint* (Differs from Boutonniere Finger where extensor tendon is suck at PIP joint) Most often involves middle finger

Mallet Finger Tx

Finger splint

Jersey Finger Physical Exam

Inability to *flex the DIP joint*

Mallet Finger vs Jersey Finger

Mallet: inability to EXTEND DIP Jersey: inability to FLEX DIP

Mallet Finger Physical Exam

Pain over dorsum of DIP *Extensor lag* due to unopposed flexion HALLMARK: *inability to extend the DIP* joint fully, resulting in a flexed DIP at rest

What is a Jersey Finger

Rupture of the *flexor digitorum profundus tendon* Usually overlooked as jammed finger Involves ring finger 75% of the time

Jersey FingerTx

Splint in flexion. Then Surgery