A staged technique for the repair of the traumatic boutonniere deformity

Boutonniere Deformity

“…Curtis et al 17 described staged procedures in the correction of chronic traumatic boutonniere deformity. If the PIP joint could not be passively corrected, the patient underwent surgery, which the authors did not describe, to treat the capsular stiffness.…”

“…If the extensor deficit was greater than 20°, the surgeon proceeded to stage IV, which consisted of direct repair or reconstruction of the central slip. Curtis et al 17 excised the central slip scar tissue and performed an end-to-end repair with dorsal imbrications of lateral band to the central slip. In 23 patients, 17 were treated with stages I through III; 6 were treated with stages I, II, and IV.…”

“…For deformities with greater loss of PIP joint extension, we cautiously offer an approach similar to that described by Curtis et al 17 after reviewing the potential complications noted earlier. The initial emphasis is on restoring passive motion through splinting and stretching the PIP and DIP joints.…”

Tractus-intermedius-Durchtrennung �ber dem Fingermittelgelenk (sog. Knopflochdeformit�t)

“…The lateral bands have slipped into a position anterior to the transverse axis of the PIP and act as flexors of the PIP [3,14]: the head of the proximal phalanx glides dorsally through the button-like defect [23].…”

“…Die Seitenzügel, die dann seitlich bis unterhalb der Mittelgelenkachse abgleiten, wirken sich flexionsverstär-kend auf das Mittelgelenk aus [3,14]: Das Grundgliedköpfchen rutscht deshalb dorsal durch den knopflochartigen Defekt [23].…”